Human Surgeryes

Mini Tummy Tuck Surgery

2011-04-01T13:06:00.000-07:00

Mini Tummy Tuck

Mini tummy tuck surgery is less invasive than traditional abdominoplasty. Find out if you are a good candidate for mini abdominoplasty, as well as information about the procedure and recovery period.

Mini Tummy Tuck Candidates

The mini tummy tuck, or partial abdominoplasty, is often an excellent option for people who have a small amount of abdominal skin to be removed and do not have a significantly protruding abdominal muscle wall. Individuals whose abdominal area is beginning to sag due to aging or who have slim abdomens that they wish to sculpt into a more desirable shape may find that a mini tummy tuck is ideal for them.

Mini (Also Known as Scarless) Tummy Tuck Surgery

Mini tummy tuck surgery may be performed under general anesthesia, but is usually completed with a local anesthetic and mild sedation. The length of the incision involved in a mini tummy tuck will depend on the amount of skin to be removed, but will generally be smaller than the incision required by a traditional tummy tuck. This is why mini tummy tuck surgery is also sometimes known as a " scarless tummy tuck." Unlike a traditional tummy tuck, the surgeon usually does not have to reposition the navel during mini abdominoplasty. If necessary, liposuction may also be performed to help sculpt the tummy into the desired shape.
Just as mini tummy tuck surgery involves a smaller incision than its traditional counterpart, it also requires that a smaller section of the abdominal wall be exposed; usually, the treatment area extends from the point of incision to the navel. After excess fat has been removed and the abdominal muscles have been tightened, the surgeon will stretch the skin downward, cutting away any excess tissue and stitching the remaining skin into place. The surgeon may place a temporary drainage tube in the incision site.

Mini Tummy Tuck Recovery

The patient is usually released from the hospital within a few hours of mini tummy tuck surgery. The recovery time is about the same as that for liposuction. Most patients experience some postoperative pain, but it can be controlled with over-the-counter medication. Patients are usually able to return to work within a few days of getting a mini abdominoplasty but should refrain from strenuous activities for a few weeks.

Length

About 1 to 2 hours.

Side Effects

Temporary swelling, discomfort, and numbness.

Recovery

Mini-tummy tuck patients will need to wear a compression garment during the healing period, which may last about two to three weeks after surgery. This procedure has a shorter recovery time than the full tummy tuck; sutures should be removed in a few weeks. Return to work: 1 to 3 weeks. Return to light activity: within 2-3 days. Avoid strenuous activity: about 1 month.

Risks

Rare possibility of infection and blood clots

Results

Long-lasting; weight fluctuation or pregnancy may affect results.

Technology

During mini-abdominoplasty, your surgeon will make a small incision directly above the pubic region. He or she will cut away loose skin and may perform liposuction in conjunction to remove excess fat. As compared to a full tummy tuck, the belly button should not have to be repositioned. The incisions are closed with small sutures and small drains are usually inserted to eliminate fluid buildup. Elastic bandages are then applied to the area and secured.

Gastric Bypass Surgery For Weight Loss

2011-03-28T13:45:00.003-07:00

Gastric bypass procedures (GBP) are any of a group of similar operations that first divides the stomach into a small upper pouch and a much larger lower "remnant" pouch and then re-arranges the small intestine to allow both pouches to stay connected to it. Surgeons have developed several different ways to reconnect the intestine, thus leading to several different GBP names. Any GBP leads to a marked reduction in the functional volume of the stomach, accompanied by an altered physiological and physical response to food.
The operation is prescribed to treat morbid obesity, defined as a BMI greater than 40, and also to treat type 2 diabetes, hypertension, sleep apnea and other co-morbid conditions.Bariatric surgery is the term encompassing all of the surgical treatments for morbid obesity, not just gastric bypasses, which make up only one class of such operations. The resulting weight loss, typically dramatic, markedly reduces comorbidities. The long-term mortality rate of gastric bypass patients has been shown to be reduced by up to 40%; however, complications are common and surgery-related death occurs within one month in 2% of patients.

Gastric bypass

Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size, which reduces the amount of food you eat and thus the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed. This leads to weight loss.
The most common gastric bypass surgery is a Roux-en-Y gastric bypass.
In normal digestion, food passes through the stomach and enters the small intestine , where most of the nutrients and calories are absorbed. It then passes into the large intestine (colon), and the remaining waste is eventually excreted.
In a Roux-en-Y gastric bypass, the stomach is made smaller by creating a small pouch at the top of the stomach using surgical staples or a plastic band. The smaller stomach is connected directly to the middle portion of the small intestine (jejunum), bypassing the rest of the stomach and the upper portion of the small intestine (duodenum).
This procedure can be done by making a large incision in the abdomen (an open procedure) or by making a small incision and using small instruments and a camera to guide the surgery (laparoscopic approach).
See a picture of a Roux-en-Y gastric bypass

What To Expect After Surgery

Most people can return to their normal activities in 3 to 5 weeks.
After surgery, you'll need to make big, permanent changes in how you eat:

You can eat only a few ounces of food at a time. Your new stomach will only hold a tiny amount of food.
You must eat very slowly and chew your food to mush. Otherwise, you may vomit often and have pain.
You won't be able to drink for 30 minutes before you eat, during your meal, and for 30 minutes after you eat. There won't be room in your stomach for both drinks and solid food.
You probably will need to take vitamins and supplements.
You may have to avoid foods that contain simple sugars-like candy, juices, ice cream, condiments, and soft drinks. Simple sugars may cause a problem called dumping syndrome. This happens because food moves too quickly through the stomach and intestines. It can cause shaking, sweating, dizziness, rapid heart rate, and often severe diarrhea.

Why It Is Done

Although guidelines vary, surgery is generally considered when your body mass index is 40 or higher or you have a life-threatening or disabling condition related to your weight.
Your doctor may only consider doing gastric bypass surgery if you have not been able to lose weight with other treatments.
The following conditions may also be required or are at least considered:

You have been obese for at least 5 years.
You do not have an ongoing problem with alcohol.
You do not have untreated depression or another major psychiatric disorder.
You are between 18 and 65 years of age.

All surgeries have risk. And it is important for you and your doctor to discuss your treatment options to decide what is best for you.

How Well It Works

Most people who have gastric bypass surgery quickly begin to lose weight and continue to lose weight for up to 12 months. One study noted that people lost about one-third of their excess weight (the weight above what is considered healthy) in 1 to 4 years. Some of the lost weight may be regained.
The laparoscopic approach showed similar results, with 69% to 82% of excess weight lost over 12 to 54 months.

Risks

Risks common to all surgeries for weight loss include an infection in the incision, a leak from the stomach into the abdominal cavity or where the intestine is connected (resulting in an infection called peritonitis), and a blood clot in the lung (pulmonary embolism). About one-third of all people having surgery for obesity develop gallstones or a nutritional deficiency condition such as anemia or osteoporosis.
Fewer than 10 out of 1000 people die after weight-loss surgery.
After a Roux-en-Y gastric bypass:

An iron and vitamin B12 deficiency occurs more than 30% of the time. About 50% of those with an iron deficiency develop anemia.
The connection between the stomach and the intestines narrows (stomal stenosis) 5% to 15% of the time, leading to nausea and vomiting after eating.
Ulcers develop 5% to 15% of the time.
The staples may pull loose.
Hernia may develop.
The bypassed stomach may enlarge, resulting in hiccups and bloating.

What To Think About

Gastric bypass surgery may increase your chances of living longer. Some studies show that people who have weight-loss surgery have a smaller chance of dying of heart problems, diabetes, or cancer.
In a gastric bypass, the part of the intestine where many minerals and vitamins are most easily absorbed is bypassed. Because of this, you may have a deficiency in iron, calcium, magnesium, or vitamins. This can lead to long-term problems, such as osteoporosis. To prevent vitamin and mineral deficiencies, you may need to work with a dietitian to plan meals, and you may need to take extra vitamin B12 as pills, shots, or nasal spray.
There is also a possibility that you may develop gallstones after gastric bypass. Sometimes the gallbladder is removed as part of the surgery. But if your gallbladder is not removed, then you may need to take medicine to prevent gallstones.
Early studies of the laparoscopic approach to surgery for obesity suggest that it reduces recovery time and postsurgery complications

Gastric Bypass Surgery

Roux-en-Y gastric bypass surgery uses a combination of restriction and malabsorption to ensure a significant weight loss. During the procedure, the surgeon creates a smaller stomach pouch. The surgeon then divides the small intestine and attaches it to the pouch. The type of connection bypasses a large portion of the small intestine, which absorbes calories and nutrients. Having the smaller stomach pouch causes patients to feel fuller sooner and eat less food; bypassing a portion of the small intestine reduces the amount of calories that can be absorbed by the body.
The physicians in the Michael E. DeBakey Department of Surgery perform the gastric bypass laparoscopically. Using this minimally invasive approach, patients heal faster and are able to return to their normal activities more quickly. They also have much less pain, infections, hernias, and overall complications.
Laparoscopic surgery involves making a series of small incisions and inserting long tube-like instruments through them. The abdomen will be filled with gas to help the surgeon view the abdominal cavity. A camera will be inserted through one of the tubes that will display images on a monitor in the operating room. In this manner, your surgeon will be able to work inside your abdomen without making a larger incision.
Specialized instruments are used to laparoscopically perform the Roux-en-Y Gastric Bypass. This is the same gastric bypass as has been performed with the traditional open approach (large incision), but with superior results.

What happens after the surgery?

On the first postoperative day, you will undergo an upper GI to confirm that there are no problems. Following this test, you will begin drinking and be discharged the next day. A follow up appointment will be scheduled in one week and then every several months afterward to ensure that you are enjoying success.

What are the risks associated with a Roux-en-Y procedure?

As with any surgery, there are risks such as bleeding, infection, or an adverse reaction to the anesthesia. Other risks include anastomotic leakage, deep venous thrombosis, pulmonary embolism, follow-up operations to correct complications, increased risk for gallstones and nutritional deficiencies such as anemia. Your surgeon will inform you of the risks prior to surgery

When can I expect to return to work and/or resume normal activities?

Light activity at home is encouraged after surgery. You can expect to return to normal daily activities, such as showering, and walking up stairs within a few days. If you are taking narcotic medications for pain, you should not drive. Return to work following a laparoscopic gastric bypass is usually between 2-4 weeks.

Who is a candidate?

The general criteria used to determine whether you're a candidate are listed below:

BMI >40
BMI 35-40 with co-morbidities (other medical conditions such as diabetes, heart disease, etc)
Well-informed, motivated patient
Previous attempts at medical weight loss programs
Absence of endocrine orders that cause obesity

Body Mass Index, or BMI is a tool for indicating weight status in adults. For more information on BMI, or to calculate your BMI, visit the CDC's website.

What can I expect as a patient?

Step 1: Submit Questionnaire: The first step is to call the Bariatric Coordinator at Baylor College of Medicine's Comprehensive Bariatric Surgery Center and obtain a packet of information and questionnaire. The phone number is 713-798-5662; please ask for Monica Flinn. The questionnaire is a detailed document asking questions about your medical history and previous weight loss attempts. You will need to fill this out completely and accurately and mail it back to the physician's office. Once the physician and his team reviews your questionnaire and considers all the factors involved with your case, they will notifiy if you can proceed to Step 2.
Step 2: Obtain referral from your Primary Care Physician (PCP) prior to attending our patient information session. In order to attend the information session we will need you to obtain a clearance letter from your PCP. At this time you should also contact your insurance company to verify that weight loss surgery is covered. If they say that they do NOT cover it, please inquire whether they have any exceptions to that policy. Often if you have certain medical conditions they will cover the surgery.
Step 3: Attend patient information session. The next step is to attend one of our free patient information sessions to assist you in determining whether weight loss surgery is for you. You are encouraged to bring a support person to this session. These sessions include detailed overviews of teh surgery, preparation for surgery and postoperative follow up. You will hear from the surgeon, psychologist, nutritionist, nurse practitioner, financial specialist, and our bariatric coordinator to ensure that all your questions and concerns are addressed. The psychologist will inform you of support groups, emotinal eating classes and other strategies for success. Our nutritionist will explain all the nutritional changes to expect and answer any questions you may have about diet, eating post-surgery, etc. This will be the same nutrionist you meet with for your nutrition consult later in the process. We then have a patient financial services representative take you through the financial process and an insurance specialist to advise you on how to get the surgery covered by your insurance company. Finally, you will meet former patients who have had the surgery and hear their stories and ask them any questions you may have about life after bariatric surgery.
Step 4: Begin preauthorization process with insurance company. There are many types of health insurance policies and many have very strict guidelines for reimbursment. Contact your insurance company for verification of coverage and review your particular policy's guidelines and referral requirements, as well as co-payments. During this step you will work closely with the physician's office to assist you with meeting your insurance company's requirements, including documentation to get your surgery approved by your insurance company. Generally documentation about past weight loss attempts are required. Obtaining this information may require some persistance. Persevere - it will be worth the time and effort.
Step 5: Meet with surgeon and set surgery date. This is fairly straightforward - you meet one-on-one with the surgeon to asses where you are in the process and further discuss the details about the surgery. This is an opportunity for you to delve into the details of your personal case and ask any questions you may still have.
Step 6: Preparation for surgery. Once a surgery date has been decided, our team members will work with you to set up your necessary appointments. Everyone will need to have a chest x-ray, blood work, nutrition consult, and psychological consult. Certain patients will also require a gastroscopy (EGD) or upper GI (UGI). During your meeting with the surgeon, we will also decide if additional medical clearance is necessary from a cardiologist, pulminologist or other medical specialist.
Step 7: Day of Surgery. Prior to surgery we will step you through all detailed pre- and post-surgery instructions. The day of surgery you will come to the hospital early with an empty stomach and let our skilled clinical team prepare and care for you!!
Step 8: Begin the process of healing and feeling better. Successful bariatric surgery begins in the operating room, but it ends in the details of your daily life. It is important to be prepared physically and mentally for the life changes you are about to experience. After surgery, staying hydrated is essential. Careful attention to nutrition and keeping a close relationship with your nutritionist is essential. It is easy to become nutrient deficient if you do not comply with post operative vitamin supplementation. Exercise is another vital component to your success. Simple walks and controlled exercise are important as your body begins to loose weight. Remember our team of exercise specialists are happy to help you create the right exercise plan for you.

Will my Insurance Company pay for the surgery?

Many insurance companies will pay for this surgery. Some will require extensive paperwork in order to do so and some will require you to meet certain criteria. The best place to start finding out your insurance plan coverage is to call them and ask if they cover bariatric surgery. If they say no, ask them if there are any exceptions to that policy. Every company has an exclusion section that explains what the company will or will not pay for. In our patient information section we have a document about how to make an appeal to your insurance company as well as a sample letter.

Tummy Tuck ( Abdominoplasty ) Surgery

2011-03-28T13:43:00.001-07:00

Abdominoplasty or "tummy tuck" is a cosmetic surgery procedure used to make the abdomen more firm. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. This type of surgery is usually sought by patients with loose tissues after pregnancy or individuals with sagging after major weight loss.

Procedures

Abdominoplasty operations vary in scope and are frequently subdivided into categories. Depending on the extent of the surgery, a complete abdominoplasty can take 1 to 5 hours. A partial abdominoplasty (Mini-Tuck Abdominoplasty) can be completed between 1 to 2 hours

Complete abdominoplasty

In general, a complete (or full) abdominoplasty follows these steps:

An incision is made from hip to hip just above the pubic area.
Another incision is made to free the navel from the surrounding skin.
The skin is detached from the abdominal wall to reveal the muscles and fascia to be tightened. The muscle fascia wall is tightened with sutures.
The remaining skin and fat are tightened by removing the excess and closing the defect.
The old belly button stalk is brought out through a new hole and sutured into place.
Liposuction is often used to refine the transition zones of the abdominal sculpture.
A dressing and sometimes a compression garment are applied and any excess fluid from the site is drained.

Partial abdominoplasty

A partial (or mini) abdominoplasty proceeds as follows:

A smaller incision is made.
The skin and fat of the lower abdomen are detached in a more limited fashion from the muscle fascia. The skin is stretched down and excess skin removed.
Sometimes the belly button stalk is divided from the muscle below and the belly button slid down lower on the abdominal wall.
Sometimes a portion of the abdominal muscle fascia wall is tightened.
Liposuction is often used to contour the transition zone.
The flap is stitched back into place.

Extended abdominoplasty

An extended abdominoplasty is a complete abdominoplasty plus a lateral thigh lift. The resulting scar runs from the posterior axillary line (when placing you open hands on your hips, the thumbs lie along the posterior axillary line.) The operation does all of the abdominal contouring of a complete abdominoplasty plus allows further improvement of the flank (waist), as well as smoothing the contour of the upper lateral thigh.

High lateral tension tummy tuck

This is an advanced technique that takes a little more than four and half hours to perform. Conventional abdominoplasty tightens muscles in a vertical line. In this new method, known as high lateral tension abdominoplasty, in addition to vertical-line tightening, muscles are tightened horizontally. The final result with this technique is a dramatically flat abdomen with significantly better-defined waistline.

Circumferential abdominoplasty

An circumferential abdominoplasty is an extended abdominoplasty plus a buttock lift. The resulting scar runs all the way around the body, and the operation is also called a Belt Lipectomy or Body Lift. This operation is most appropriate for patients who have undergone massive weight loss.

Combination procedures

An abdominoplasty is a component of a lower body lift and can be combined with liposuction contouring, breast reduction, breast lift, or occasionally hysterectomy, depending on the reason for the hysterectomy. A popular name for breast enhancement procedures performed in conjunction with an abdominoplasty is a "mommy makeover". Recent literature in MEDLINE also has noted implementation of barbed suture in these procedures.

Recovery

Depends on the problem to be treated, surgical technique(s), and other factors. Can take one to four weeks and patients are advised to take at least a portion of this recovery time off from work.
Heavy activity especially is best avoided during this time.
Initially there may be bruising and discomfort.
A supportive abdominal binder or compression garment can minimize swelling / bruising, and support the repaired tissues.
Patients are advised to avoid all forms of nicotine for a month or longer prior to surgery and also during the recovery period.
Full recovery takes 3 – 6 months, with further fading of scars thereafter.

Risks

Abdominoplasty carries certain risks that may be serious or life-threatening. When taking the decision to undergo such a procedure it is recommended to compare the benefits with the potential risks and complications. Hence, all patients must be informed on all the risks they are exposing themselves to.Although "tummy tucks" are considered safe procedures, as with any other type of surgery, different complications may arise. The majority of the risks can be avoided if the patients follow carefully the instructions they receive from their surgeon. Severe complications occur however in rare cases and these include blood clots, thrombosis, cardiac and pulmonary complications or infection.
Infection and blood clots are a serious potential risk after abdominoplasty, but which occur rarely. Infection is usually treated with antibiotics and drainage. Patients are recommended to move around as soon as possible after surgery to minimize their risks of developing blood clots. Pulmonary embolism, heart attack or stroke are very rare complications that may result after any type of surgery due to immobility after surgery which results in blood clots that may travel to the heart, lung or brain. Thus, pulmonary embolism is a serious risk after "tummy tuck" procedure and if they occur, they commonly happen within 3 weeks of the surgery, but more commonly within the first 72 hours after the procedure has been performed.
If complications occur, they usually delay the healing process. In rare cases, another surgery is needed to fix a potential complication. Skin necrosis is one of the complications that may require another procedure as the dead skin must be replaced by a skin graft. Although necrosis is extremely rare, smokers have an increased risk to develop skin necrosis. Stopping nicotine use and smoking several weeks before and several weeks after surgery cleans the body and improves the chance of an uneventful recovery.
One of the more common problems after an abdominoplasty is collection of fluid under the skin after the drains have been removed. Your surgeon can aspirate the fluid with a needle. The drainage stops within a month and does not affect the final results.
The scars resulting from abdominoplasty are long, brutal in appearance, and permanent. The size of the scar depends on the amount of skin that has been cut-off, the techniques used for the surgery, the surgeon's skills, and the body's ability to recover. Although this scar will never become invisible, it is usually placed under the swimsuit line so it is covered by clothes. It normally takes 9 months to a year before scars flatten out and lighten in color.
Possible risks of abdominoplasty include:

Bleeding
Fluid accumulation
Poor wound healing
Skin loss
Numbness or other changes in skin sensation
Anesthesia complications
Skin discoloration and/or prolonged swelling
Fatty tissue found deep in the skin might die (fat necrosis)
Major wound separation
Asymmetry
Recurrent looseness of skin
Pain, which may persist
Persistent swelling in the legs
Nerve damage
Possibility of revisional surgery
Hematoma (may occur in 3 to 4% of cases)
Keloid (heavy scar)
Seroma
Suture rupture
Swelling
Visible scar
Death

Cost

The cost of a "tummy tuck" varies from country to country and even within locales of countries. As with most cosmetic surgery operations, the cost depends on a variety of factors like the age of the patient, their weight and the state of their health. Depending on the individuals, there may also be other costs involved after the operation. This does not include the follow-up visits as required by some doctors.
On average in the United States, this procedure can cost from USD$4,000 to as much as $20,000.
The pre-operative and post-operative care, facility fees, anesthesia, and medications must be taken into consideration when reviewing surgery costs. No surgeries are a guaranteed success and therefore a second procedure or a touch-up may be required to achieve the desired appearance. These costs are typically not included in the original cost

Related procedures

Liposuction, also known as lipoplasty, is a cosmetic surgical procedure that slims and reshapes specific areas of the body by removing excess fat deposits, improving the body's contours and proportion, and ultimately, enhancing the patient's self-image. Liposuction involves the use of a small stainless steel tube, called a cannula. The cannula is connected to a powerful suction pump and inserted into the fat through small incisions in the skin. Fat removal is accomplished as the suction cannula creates tiny tunnels through the fatty layers. Liposuction can be performed on both men and women. Ideal for this type of procedure are non-smokers, healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing, adults within 30% of their ideal weight who have firm and elastic skin.
Body contouring is a general term that refers to various plastic surgeries performed to different parts of the body with the aim of improving the shape and tone of the underlying tissue that supports fat. It is a common procedure performed for people who have undergone major weight loss. It may be performed in both men and women.
Breast reduction, or reduction mammoplasty, is the cosmetic surgery used in resizing the breast, in women with oversized breasts and men who suffer from gynecomastia. It is an overall safe procedure and most of the patients are pleased with the results. This type of surgery is performed to treat a breast condition known as hypertrophy, which refers to oversized breasts. This condition usually occurs in both breasts and commonly develops at puberty or immediately after.
Breast lift, also referred to as mastopexy, is the surgical procedure that removes the excess skin and tightens the surrounding tissue of the breast, resulting in raising and firming the breast. Mastopexies carry a certain degree of risks as any other type of surgery does. They are however safe procedures and the risks are minimized if the patients follow the surgeon's instructions.
'Hysterectomies are sometimes performed with abdominoplasty. A hysterectomy consists in removing the uterus and it may be complete (when the body, fundus and cervix are removed) or partial (when only the uterine body is surgically removed). This procedure is normally performed by gynecologists and it is one of the most common gynecological surgeries. This type of surgery is used to treat some benign tumors, cancers of the ovaries, uterus or cervix, endometriosis and are also performed in transmen.

Length of surgery
Between 2 and 4 hours, according to the complexity of the case.

How is tummy tuck performed?

The surgeon makes a long incision across the abdomen right above the pubic area. Usually, the incision has a curvature that is similar to the outline of a bikini so that the future scar will be easier to conceal under your underwear. In most cases it is necessary to make a circular incision around the navel so that it will remain in its original place, in spite of the shifting of the rest of the abdominal skin.Then, the surgeon separates the skin from the abdominal wall all the way up to the ribs, exposing the abdominal muscles. These muscles are tightened by bringing them close together and joined in the middle vertical line; this will make your abdominal muscles firmer and your waist narrower. The skin that was separated is stretched towards the pubis, the excess skin is removed and the navel is placed in its new position. Finally, the surgeon makes the sutures, and applies a bandage and a temporary drainage tube to eliminate the excess fluids.

What does tummy tuck surgery do?

It helps to remove the excess skin and fat deposits that appear as a consequence of regnancies, old age and obesity, when the whole abdominal area is affected. When the affected area is smaller, located at the lower section of the abdomen below the navel, it is better to perform a mini-abdominoplasty. It removes stretch marks or scars that may be in the area. If necessary, the abdominal muscles may be tightened by means of a vertical fold in the middle, this will make your abdomen look firmer and your waist narrower. At the same time, it may also help to solve preexisting problems, such as hernias or eventrations.

What does tummy tuck surgery NOT do?

It is not indicated for treating obesity. If you suffer from obesity, we recommend that you visit the section of our site devoted to bariatric surgery. It is not used for removing fat deposits when they are small and the skin has a good elasticity. If this is your case, and diets and physical exercise do not produce the desired results, liposculpture is the right thing for you.

Tummy Tuck ( Abdominoplasty ) Surgery

2011-03-28T13:42:00.001-07:00

Procedures

Abdominoplasty operations vary in scope and are frequently subdivided into categories. Depending on the extent of the surgery, a complete abdominoplasty can take 1 to 5 hours. A partial abdominoplasty (Mini-Tuck Abdominoplasty) can be completed between 1 to 2 hours

Complete abdominoplasty

In general, a complete (or full) abdominoplasty follows these steps:

An incision is made from hip to hip just above the pubic area.
Another incision is made to free the navel from the surrounding skin.
The skin is detached from the abdominal wall to reveal the muscles and fascia to be tightened. The muscle fascia wall is tightened with sutures.
The remaining skin and fat are tightened by removing the excess and closing the defect.
The old belly button stalk is brought out through a new hole and sutured into place.
Liposuction is often used to refine the transition zones of the abdominal sculpture.
A dressing and sometimes a compression garment are applied and any excess fluid from the site is drained.

Partial abdominoplasty

A partial (or mini) abdominoplasty proceeds as follows:

A smaller incision is made.
The skin and fat of the lower abdomen are detached in a more limited fashion from the muscle fascia. The skin is stretched down and excess skin removed.
Sometimes the belly button stalk is divided from the muscle below and the belly button slid down lower on the abdominal wall.
Sometimes a portion of the abdominal muscle fascia wall is tightened.
Liposuction is often used to contour the transition zone.
The flap is stitched back into place.

Extended abdominoplasty

High lateral tension tummy tuck

Circumferential abdominoplasty

Combination procedures

Recovery

Depends on the problem to be treated, surgical technique(s), and other factors. Can take one to four weeks and patients are advised to take at least a portion of this recovery time off from work.
Heavy activity especially is best avoided during this time.
Initially there may be bruising and discomfort.
A supportive abdominal binder or compression garment can minimize swelling / bruising, and support the repaired tissues.
Patients are advised to avoid all forms of nicotine for a month or longer prior to surgery and also during the recovery period.
Full recovery takes 3 – 6 months, with further fading of scars thereafter.

Risks

Bleeding
Fluid accumulation
Poor wound healing
Skin loss
Numbness or other changes in skin sensation
Anesthesia complications
Skin discoloration and/or prolonged swelling
Fatty tissue found deep in the skin might die (fat necrosis)
Major wound separation
Asymmetry
Recurrent looseness of skin
Pain, which may persist
Persistent swelling in the legs
Nerve damage
Possibility of revisional surgery
Hematoma (may occur in 3 to 4% of cases)
Keloid (heavy scar)
Seroma
Suture rupture
Swelling
Visible scar
Death

Cost

Related procedures

Length of surgery
Between 2 and 4 hours, according to the complexity of the case.

How is tummy tuck performed?

What does tummy tuck surgery do?

What does tummy tuck surgery NOT do?

Mesotherapy Surgery

2011-03-26T13:45:00.000-07:00

Mesotherapy (from Greek mesos, "middle", and therapy from Greek therapeia, "to treat medically") is a non-surgical cosmetic medicine treatment. Mesotherapy employs multiple injections of pharmaceutical and homeopathic medications, plant extracts, vitamins, and other ingredients into the subcutaneous fat. Mesotherapy injections allegedly target adipose fat cells, apparently by inducing lipolysis, rupture and cell death among adipocytes.

Melting Fat with Mesotherapy

Many women suffer from cellulite, whether or not they are overweight. Mesotherapy is a newer procedure used to treat cellulite. Mesotherapy cost is quite high, but many people feel that the mesotherapy results are worth the cost. But what are the risks of mesotherapy? Does mesotherapy work? And what are the costs of mesotherapy? These questions are important considerations when weighing the mesotherapy risks against the benefits.

What is Mesotherapy?

Mesotherapy is a treatment for the ugly look of cellulite and body fat. It is not a surgical procedure, but rather uses injections of several substances, including vitamins, plant extracts, medications, and more, into the fat under the skin. This is supposed to killing the fat cells, which are then absorbed into the body, creating a more sculptured body.

There are many different mesotherapy medications that make up the cocktails that are used in the treatment. There is no current research showing what concoctions are the best to use in the procedure. Doctors know that the procedure kills cells, but what is not certain is whether or not the procedure specifically targets fat cells.

History of the Procedure

The procedure was first researched by Dr. Michel Pistor, in the early 1950s. The name of the procedure was given by the French Press in 1952. Since that time, the procedure has become widely practiced throughout the world, including in Europe and South America. There is some controversy and criticism about mesotherapy in modern medical circles.

Purpose of Mesotherapy

The purpose of the mesotherapy is to reduce fat and cellulite deposits in the problem areas of the body. The most commonly targeted areas are the upper arms, thighs, abdomen, and rear end. Often the doctor will create a concoction specific for the patient. It is used to help lose weight, sculpt the body, and rejuvenate the skin. But does mesotherapy work, and how is it different than liposuction?

Mesotherapy Versus Liposuction

The main difference between mesotherapy and liposuction is that liposuction is an invasive, surgical procedure where fat is vacuumed out of the body. Mesotherapy is non invasive, and simply uses mesotherapy medication injections to help reduce the amount of fat cells in the body. There are fewer risks and a no recovery time with mesotherapy as compared to liposuction. Finally the mesotherapy cost is much lower than the cost of liposuction, since it is not surgical.

The Mesotherapy Procedure

Mesotherapy is performed during outpatient sessions of less than an hour each. A typical course of treatment consists of ten sessions, though many patients see results after the first few sessions. Recovery from mesotherapy is so simple that patients can immediately return to their daily routines. Learn more about the mesotherapy procedure, including what to do before mesotherapy treatment, the recovery process, and the results you can expect.

Mesotherapy Risks and Benefits

The benefits and side effects of mesotherapy should be weighed before you decide whether this treatment is best for you. Mesotherapy carries few risks, especially compared to liposuction and other invasive body contouring procedures. Conversely, mesotherapy has several marked benefits. Mesotherapy is able to eliminate cellulite and localized fat deposits with minimal trauma to the tissues, little swelling or bruising, and low risk of other side effects.

Mesotherapy Prices

Learn about mesotherapy prices and how financing plans can put mesotherapy within your financial reach. Though the cost of mesotherapy varies depending on the locale, the doctor, and the area being treated, treatment sessions generally cost between $200 and $600. Many doctors allow patients to make monthly installments, spreading the cost of treatment over time.

Macrolane Surgery

2011-03-26T13:05:00.000-07:00

Macrolane is a breast and body-contour filler marketed by Q-Med in the UK since early 2008. It has received attention as a less invasive alternative to surgical breast enlargement, offering an increase of one cup size through injections that only take between 30 and 90 minutes - heralding the term "30 minute boob job".
The treatment involves injecting stabilised hyaluronic acid into the breast, buttock or other areas, and then moulding to the desired shape.The benefits are that it requires only a local anaesthetic and will leave no scarring, although bruising, swelling and discomfort for a few days are expected. The effect however only lasts for 12 months, after which further injections are required. The procedure has also drawn criticism as its long term effects are relatively unknown. In 2009 the journalist Alice Hart-Davis described the problems that she experienced after having the procedure. The only medical trial was supported by the manufacturers, involving 1000 patients in Japan, and anybody taking the procedure will be entered into a European-wide research trial
Initially, treatment in the UK was reasonably expensive, costing about £3000 for the initial injections, followed by £1400 for repeat injections each year in order to maintain the effect.The cost of initial injections has dropped as the treatment grows in popularity

Macrolane non-invasive injectable breast and body shaping treatment
In past years, the latest option for non surgical, scarless breast augmentation is an injection known as the Macrolane filler. Less invasive than plastic surgery, Macrolane breast injection restores volume simply and more safely. Macrolane breast injectionMacrolane breast and body shaper gel contains stabilized hyaluronic acid. Hyaluronic acid is a natural component of our skin . Macrolane injcetion- the first breast and body shaping treatment using hyaluronic acid. It is based on Q-Med's unique patented NASHA™ technology (Stabilized Non-Animal Hyaluronic Acid) which has been used in over 9 million treatments in over 70 coutries worldwide. Use of NASHA has been clinically proven and well documented in facial aesthetics for over 10 years. Photo: Example of Macrolane treatment
Macrolane breast enchancer is injected deep into the subcutis under local anaesthetic. Macrolane VRF filler comes in two formulations that can be injected seperately or in combination to ensure full correction and smoothness of the skin surface. The formulation and volume of Macrolane filler used (either VRF 20 or VRF 30) will be dependant on the individual and treatment area. Dr Rodigo will advise you at your consultation the most appropriate treatment procedure. Women who are considering breast augmentation with Macrolane breast filler will want to be reassured that the implant will not adversely affect the efficiency of future mammograms and/or the breast tissue itself. In one study, mammography after Macrolane breast filler injection for breast augmentation was evaluated. It was concluded that mammograms from these patients were easy to evaluate. Furthermore, routine supplementation of mammography with MRI does not appear necessary in patients treated with Macrolane breast injection . For the breast enlargement with Macrolane to increase of 1 cup size you need volume of 100ml in each side. The procedure is performed under local anaesthetic and takes about 30 minutes.It lasts about 1 year and can be repeated as and when desired.It can be used in all parts of the body. in women and men including for penile enhancement.
Anesthesia The operation performed under a general anesthesia. Inpatient This is a major inpatient procedure. Duration of operation Breast asymmetry correction usually takes 2 to 2.5 hours, depending upon the extent of the work needed. Time of Recovery Usually within 2 weeks. The patient is able to resume normal activity, except for lifting. Required minimum stay in Budapest 10 days. Possible risks and complications Breast asymmetry correction is a major invasive plastic surgery. When performed by a qualified plastic surgeon, one trained in body contouring, the results are normally very satisfactory. However, as with all surgical procedures, there are some risks associated with breast asymmetry correction . There are also specific complications associated with the procedure. These include: infection, nipple asymmetry and poor healing, which can result in heavy scarring. Infection can be treated with antibiotics and drainage. You can reduce your risks by closely following your surgeon's instructions both before and after plastic surgery. The specific risks and the suitability of this procedure for a given individual can only be determined at the time of consultation. All plastic and cosmetic surgical procedures have some degree of risk. After care After the plastic surgery you may be swollen and in pain, which can be controlled by medication. Depending upon the type of surgery performed, you may be remain hospitalized for up to 2 days. Your doctor will give you instructions in your post-operative care.If you feel any severe pain, call your surgeon immediately. Most of the swelling and bruising should disappear within two weeks or so.Your surgeon will let you know when you are ready for exercise. During your healing period avoid drinking alcohol, which can lead to fluid retention and delay recovery. Results Most patients are extremely happy with breast asymmetry correction. There is a certain amount of increased self esteem and self confidence which may result.The degree of improvement varies from patient to patient.

What is the Macrolane procedure?

The procedure is quite simple. It involves you being given a local anaesthetic to numb the area to be treated‚ followed by the making of a small incision in that area. The doctor will use a thin tube or cannula to inject the Macrolane gel into the subcutaneous layer (inner layer) of the skin.
You may be prescribed antibiotics either before or after treatment to reduce the risk of an infection.

How much does Macrolane cost?

This depends on what part of the body is being treated and the amount of gel used.
As you can imagine‚ the greater the area and volume of gel used‚ the greater the cost. Prices can range from £1‚500 up to £3‚000.
Costs of Macrolane vary between clinics so you will need to obtain a few quotes before making a decision.

Benelli Lift Surgery

2011-03-25T15:18:00.000-07:00

Benelli Lift

Wanting to "put back where they belong" small drooping breasts? Or just wishing to have a breast lift? But beset with anxieties regarding general anesthesia, time and financial constraints on the common/conventional breast lifts?
Then, read on and find another alternative to having your wish granted with a Benelli Lift.
What is the Benelli Lift and how is it done?
Dr. Louis Benellito conceived of this procedure to boost smaller breasts whose elasticity has been spent. In this procedure, the surgeon removes a ring of soft tissue around the areola (shaped like a doughnut) which makes the lifting of the breast uncomplicated and brief. Clinically, this is called a doughnut Mastopexy and a concentric Mastopexy.
The Benelli Lift usually results in only a scar around the areola which levels out and fades in time. After the doughnut-shaped tissue around the areola is removed, the surgeon sews up the adjoining tissue to the rim of the areola with purse string sutures.
The breast is lifted by the tightening of the sutures, producing a flatter, rounded breast. The scarring is minimal because there are fewer incisions than the traditional breast lift and this is usually done as an outpatient procedure with local anesthesia administered.
The only hitch to this procedure is that you cannot have breast implant augmentation done simultaneously.
You should consult only with a board certified plastic surgeon who has been trained in the Benelli technique. You can ask to see before and after photos before any discussion of your expectations and long term plans with your chosen surgeon.
Recovery
You can expect an easy recovery from a Benelli lift. Patients usually get back to work within a week of the operation.
Take note, the full effects of the Benelli lift take up to a year, sometimes, to be seen. You should also discuss with your surgeon any future procedures that might be needed to maintain the effect. You cannot argue with time, nor gravitational effects, your weight may go up or down, which could call for a touch-up procedure later.
In cases where the breasts had been almost totally stretched, your nipple might have to be moved. Here, the surgeon will be making a vertical incision aside from the doughnut-shaped cut.
Any Risks?
Customary risks connected to traditional breast lifts (like anesthesia complications or even risk of death) are absent in the Benelli lift because it's local anesthesia that is used here. Only the complications arising from any breast alteration surgeries may be expected, a drop in nipple sensation, infection, slow healing or a loss of areola tissue. Choosing a qualified cosmetic surgeon definitely reduces risks for you. Whomever you may choose, a candid discussion with your surgeon will definitely help you understand the results and risks of this operation.

Benelli Breast Lift Procedure

In a Benelli mastopexy, the surgeon makes an incision around the entire outer border of the areola. The doctor will then create another incision in the breast skin which surrounds the first areolar incision. This second incision might be symmetrical to the original, but is more likely to be wider at the top of the nipple, with more skin removed from the upper breast. The excess skin, roughly in the shape of a donut, is removed and the surgical wound carefully closed using special sutures. This procedure will raise the areola by 3 to 5 centimeters and the nipple by 2.3 to 4 centimeters when performed properly.

Benelli Mastopexy Indications

The Benelli mastopexy is used for women with mild to moderate breast ptosis. It is effective as a stand alone procedure to firm the breast and eliminate sagging resulting from age or childbirth related issues. The procedure will have moderate long term lifting results, although the effects of age and lifestyle will continue to cause breast ptosis in the future. This mastopexy is a great addition to a periareolar breast augmentation since it can utilize the same surgical incision and really help to improve the aesthetics of postoperative augmented breasts. This procedure works best when performed with a subpectoral or submuscular implant placement to avoid immediate gravitational stress on the new incision.

Benelli Breast Lift Recommendation

The Benelli mastopexy is one of the best minimally invasive breast lift procedures and can achieve really fantastic results with only minor scarring. An excellent surgeon can create a surgical wound which will heal so nicely that the evidence of the procedure might be barely visible. When used in combination with an augmentation surgery, the Benelli lift is one of the best methods of increasing breast size and firmness, with the least risk for noticeable scarring. Talk to a qualified cosmetic surgeon to determine if the Benelli mastopexy might be an important component of your self improvement plan.

Nipple Reconstruction Surgery

2011-03-25T15:05:00.000-07:00

Nipple Areola Reconstruction

Creating the nipple areola is the final component to making your breast reconstruction complete. There have been numerous approaches to nipple reconstruction over the last 30 years, and with several options available, surgeons can utilize whichever method is most suitable for their patients. There is no one absolute best method of nipple reconstruction for all patients. Some patients are comfortable without having a nipple, and do not wish to have further surgery. Others choose the non-surgical option of tattooing without reconstruction. This allows color pigmentation to simulate the nipple areola without the contour of an actual nipple. Still, the reconstruction of the nipple areola helps to put the finishing touches on the new breast after a long journey in reconstruction.

After optimal symmetry between the breasts has been achieved, the nipple areola reconstruction can be done. There are a number of factors that help determine which method of nipple reconstruction is right for you. These include the quality of tissue on the reconstructed breast, and whether you are having nipple reconstruction with or without a surrounding graft. Even more important, is your surgeon’s preference.

Historically, one technique included sharing a piece of the nipple from the opposite breast. This surgery is not used today, because it transfers breast tissue to the reconstruction that could potentially form a new cancer. Another method used in the past involved taking a full thickness skin graft from the labia to create a dark colored areola. This outdated technique leaves a scar in an undesirable location. Also, these grafts may be hair bearing, and areolar pigment is easier achieved with medical tattooing.

In modern approaches to nipple reconstruction, the nipple mound is created from skin taken as a local flap on the reconstructed breast. Various local flaps have been described, including the Skate flap, the C-V flap and the Star flap. Regardless of which approach your surgeon chooses, the outcome will be a nipple mound. The areola can then be either tattooed, or it can be reconstructed with a skin graft taken from elsewhere on the body. Common donor sites for the graft include the abdominal scar from a flap reconstruction, the inner thigh, or the buttock crease.

All nipple reconstructions lose some projection over time as part of the normal wound healing process. The risk of wound complications in nipple reconstruction is very low in patients with no history of prior radiation, but common in the radiated breast. In the case of failed nipple reconstruction, it may be necessary to revise the reconstruction with another local skin flap. Sometimes, the use of dermis or fat grafts, and fillers such as Radiesse, may be necessary to improve nipple projection. AlloDerm® has also been utilized by some surgeons at the time of nipple reconstruction to maximize projection and correct flattening.

Nipple reconstruction is done as an outpatient, ambulatory procedure. The rate of recovery depends on what other revisions are done simultaneously, and where the donor site for the areola graft is located. Once you have healed, you will have the tattooing done in your surgeon's office. Refer to the Nipple Areola Tattoo section for details on this procedure. Also you may refer to the Post-Operative Nipple Reconstruction section to learn about care after nipple surgery.

Procedure

The history of nipple reconstruction parallels that of breast reconstruction with autologous tissue, from the development of the latissimus dorsi flap by Tanzini in 1906 to modern transverse rectus abdominus myocutaneous (TRAM) and microvascular-free TRAM breast reconstruction.

Historically, nipple-areola complex reconstruction has been considered a secondary procedure to the more important breast mound reconstruction. To optimize positioning of the nipple, surgeons generally recommend waiting until complete settling of the reconstructed breast before performing nipple reconstruction. However, when nipple reconstruction is delayed for months to years, final reconstruction is often never completed, as patients often opt to minimize their exposure to further surgical procedures. Most recently, some have advocated immediate nipple reconstruction in free TRAM flap reconstructions to minimize operative procedures and to achieve earlier completion of the breast reconstruction.⁵
Nipple reconstruction techniques have evolved significantly over the years. From simple tattooing to the more technologically advanced, although rarely available, tissue engineering,⁶today's techniques are able to provide long-lasting, satisfactory reconstruction with minimal morbidity.

Indications

Nipple-areola reconstruction represents the completion of the breast restorative process and has significant psychological implications for women who undergo mastectomy. Nipple size, position, projection, and color are determining factors in the aesthetic symmetry of the reconstruction, qualifying an otherwise nondescript flesh mound as the new breast. Complete nipple-areola reconstruction with tattoo can visually draw attention away from the scars on the reconstructed breast mound. In addition, autologous flap breast reconstruction following skin-sparing mastectomy can usually be designed so that the entire flap skin paddle, along with the scar, is tattooed as an areola.

The benefit of nipple-areola reconstruction is supported by the findings of a retrospective psychological survey comparing the level of satisfaction of women who underwent breast reconstruction with or without nipple-areola reconstruction; a highly significant correlation was seen between level of satisfaction and presence of the nipple-areola complex. Artists and anatomists consider the nipple-areola complex an essential and defining component of the breast aesthetic unit, and the physical characteristics of the nipple gain importance as the breast mound decreases in size. Reconstruction of position, size, shape, and color of the native nipple-areola complex currently are attainable goals; functional restoration of erectile ability and erogenous sensation are goals for future reconstructive surgeons.

Relevant Anatomy

Nipple-areola anatomy is remarkably variable in dimension, texture, and color across ethnic groups and among individuals. Moreover, an appreciable difference often exists in the two nipple-areola complexes in the same patient. The presence of an elevated structure in the center of a pigmented area on the breast mound usually represents a nipple, yet wide variability exists as to what constitutes the normal dimensions of the complex. In general, an aesthetically balanced B-C cup breast has an areola diameter of 4.2-5 cm, with the nipple diameter and projection or height equal to one third to one fourth of the areola diameter.
The central position of the nipple cylinder in the areola also has significant variability, ranging from one fourth to one half of the radius off-center.
Nipple projection results from the primary location of the mammary ducts in the central portion of the nipple complex. This arrangement produces a semi-rigid structure with a significantly more fibrotic element than the soft and pliable surrounding areola. The contractile properties of the areola also contribute to the gradual change in nipple projection obtained with direct or neural stimuli.
Most methods of nipple reconstruction can be used whether the breast has been reconstructed with a flap or alloplastic materials. Flaps generally provide more mobile tissue and make it easier to achieve nipple bulk and projection. Previous scars from the mastectomy or previous biopsies need to be accounted for in terms of flap design so as not to compromise blood supply to the reconstructed nipple.

Breast Reconstruction Surgery

2011-03-25T14:12:00.000-07:00

Breast reconstruction is the rebuilding of a breast, usually in women. It involves using autologous tissue or prosthetic material to construct a natural-looking breast. Often this includes the reformation of a natural-looking areola and nipple. This procedure involves the use of implants or relocated flaps of the patient's own tissue.

Techniques

There are many methods for breast reconstruction. The two most common are:

Tissue Expander - Breast implants This is the most common technique used in worldwide. The surgeon inserts a tissue expander, a temporary silastic implant, beneath a pocket under the pectoralis major muscle of the chest wall. The pectoral muscles may be released along its inferior edge to allow a larger, more supple pocket for the expander at the expense of thinner lower pole soft tissue coverage. The use of acellular human or animal dermal grafts have been described as an onlay patch to increase coverage of the implant when the pectoral muscle is released, which purports to improve both functional and aesthtic outcomes of implant-expander breast reconstruction.
- In a process that can take weeks or months, saline solution is percutaneously injected to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a more permanent implant. Reconstruction of the areola and nipple are usually performed in a separate operation after the skin has stretched to its final size.
Flap reconstruction The second most common procedure uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen. This procedure may be performed by leaving the donor tissue connected to the original site to retain its blood supply (the vessels are tunnelled beneath the skin surface to the new site) or it may be cut off and new blood supply may be connected.
- The latissimus dorsi muscle flap is the donor tissue available on the back. It is a large flat muscle which can be employed without significant loss of function. It can be moved into the breast defect while still attached to its blood supply under the arm pit (axilla). A latissimus flap is usually used to recruit soft-tissue coverage over an underlying implant. Enough volume can be recruited occasionally to reconstruct small breasts without an implant.
- Abdominal flaps The abdominal flap for breast reconstruction is the TRAM flap or its technically distinct variants of microvascular "perforator flaps" like the DIEP/SIEP flaps. Both use the abdominal tissue between the umbilicus and the pubis. The DIEP flap and free-TRAM flap require advanced microsurgical technique and are less common as a result. Both can provide enough tissue to reconstruct large breasts. The contour of the lower abdomen is reliably improved by these procedures which remove the same tissue as an abdominoplasty (tummy tuck.) TRAM flap procedures may weaken the abdominal wall and torso strength, but are tolerated well in most patients. To prevent muscle weakness and incisional hernias, the portion of abdominal wall exposed by reflection of the rectus abdominis muscle may be strengthened by a piece of surgical mesh placed over the defect and sutured in place. Perforator techniques such as the DIEP (deep inferior epigastric perforator) flap and SIEA (superficial inferior epigastric artery) flap require precise dissection of small perforating vessels through the rectus muscle, and purport the advantage of less weakening of the abdominal wall, though rectus abdominus muscle function may still be compromised. Other total autologous tissue breast reconstruction donor sites include the buttocks (superior or inferior gluteal artery perforator flaps (SGAP or IGAP)). The purpose of perforator flaps (DIEP, SIEA, SGAP, IGAP) is to provide sufficient skin and fat for an aesthetic reconstruction while minimizing morbidity from harvesting the underlying muscles.

The TRAM Flap Procedure

Identification of the target and donor sites	Raising the flap and transposing it to the target site	The result of the reconstruction

Other considerations

Nipple reconstruction is usually delayed until after the breast mound reconstruction is completed so that the positioning can be planned precisely. There are several methods of reconstructing the nipple-areolar complex, including:

Nipple-Areolar Composite Graft (Sharing) - if the contralateral breast has not been reconstructed and the nipple and areolar are sufficiently large, tissue may be harvested and used to recreate the nipple-areolar complex on the reconstructed side.
Local Tissue Flaps - a nipple may be created by raising a small flap in the target area and producing a raised mound of skin. To create an areola, a circular incision may be made around the new nipple and sutured back again. The nipple and areolar region may then be tattooed to produce a realistic colour match with the contralateral breast.
Local Tissue Flaps With Use of AlloDerm - as above, a nipple may be created by raising a small flap in the target area and producing a raised mound of skin. AlloDerm (cadaveric dermis) can then be inserted into the core of the new nipple acting like a "strut" which may help maintain the projection of the nipple for a longer period of time. The nipple and areolar region may then be tattooed later

One of the challenges in breast reconstruction is to match the reconstructed breast to the mature breast on the other side (often fairly 'ptotic' - droopy.) This often requires a lift (mastopexy), reduction, or augmentation of the other breast.

Recovery

Recovery from implant-based reconstruction is generally faster than with flap-based reconstructions, but both take at least three to six weeks of recovery and both require follow-up surgeries in order to construct a new areola and nipple. All recipients of these operations should refrain from strenuous sports, overhead lifting, and sexual activity during the recovery period. TRAM flap patients can show abdominal-muscle weakness on EMG studies, but clinically most patients who have undergone unilateral breast reconstruction (reconstruction of one breast only) return to normal activities after recovery.
Patients who have undergone bilateral breast reconstruction with TRAM flaps (i.e. reconstruction of both breasts) require sacrifice of both rectus muscles and tend to have permanent abdominal strength loss. For this reason, many plastic surgeons now frown upon bilateral breast reconstruction with TRAM flaps. This also explains the significant patient interest in perforator flap techniques such as the DIEP flap which preserves abdominal muscle function long-term. These patients tend to return to full activity after several weeks without permanent limitations.
There is little information about upper body exercise post-mastectomy. Issues such as simple mastectomy, mastectomy with reconstruction, and mastectomy with lymph node excision and reconstruction all factor into limitations to amount and extent of upper body exercise. Generally, cardiac exercise (treadmill, walking, etc.) are approved for rehabilitation post-surgery and for weight control.
Women who have undergone breast reconstruction must still be followed for local or regional recurrence of their cancer with manual exams of the breast/chest wall and axilla.
The most effective relief from breast reconstruction is hilotherapy, a therapy that provides relief from hematoma, pain, and swelling post-surgery without the dangers of frostbite and skin necrosis.

Overview

The primary part of the procedure can often be carried out immediately following the mastectomy. As with many other surgeries, patients with significant medical comorbidities (high blood pressure, obesity, diabetes) and smokers are higher-risk candidates. Surgeons may choose to perform delayed reconstruction to decrease this risk. Patients expected to receive external beam radiation as part of their adjuvant treatment are also commonly considered for delayed autologous reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients.
Breast reconstruction is a large undertaking that usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revisional surgeries.
Outcomes based research on quality of life improvements and psychosocial benefits associated with breast reconstruction served as the stimulus in the United States for the 1998 Women's Health and Cancer Rights Act, which mandated health care payer coverage for breast and nipple reconstruction, contralateral procedures to achieve symmetry, and treatment for the sequelae of mastectomy. This was followed in 2001 by additional legislation imposing penalties on noncompliant insurers. Similar provisions for coverage exist in most countries worldwide through national health care programs.

Breast Implant Revision Surgery

2011-03-25T13:39:00.000-07:00

Breast implant revision

Breast implant revision is a type of plastic surgery , during which earlier inserted implants can be replaced with new ones or removed completely. Earlier only silicone implants were used. Nowadays, saline-filled breast implants are considered to be safer ones, since they are filled with salt water, that can be absorbed by the organism in case of leakage. Many women have breast implant revision in order to have their old silicone implants replaced with saline-filled implants or with newer silicone implants. Life of older silicone implants is about ten years. Therefore, such implants should be removed and replaced with new ones.

Another reason why women decide to have breast implant revision surgery is because for some reason they want to have natural breasts or smaller breast implants. In such case, breast implants are either removed completely or replaced with smaller breast implants.
In addition, some of the breast implants become deformed or shifted, and breasts will look asymmetrical. In such case the breast implant revision procedure is needed to restore normal symmetrical appearance of the breasts. A woman can either choose to have the same size of the breast implant or different size of implant placed.

Breast implant revision

After your initial consultation, during which you and your doctor will discuss problems related to your older breast implants , reasons why you think you need breast implant revision procedure, and your desired appearance after surgery, you will have time for the procedure set. Breast implant revision procedure should take from two to three hours depending on the technique used, problems related to former breast augmentation procedure, asymmetry of the breasts and other.
An incision is made in order to remove older implants and insert new ones if desired by the patient. The place of incision is below the breast, in the underarm, around the areola or through the belly-button. Most frequently the surgeon takes the existing breast implants through the same incision areas as they were placed before. This way no additional scars are made.
Breasts implants are inserted either under the chest muscle or above it. It depends upon the former breast augmentation procedure, patient’s anatomy of the breasts, contractures and other. You should discuss different possibilities, their advantages and disadvantages with your doctor before this plastic surgery procedure.
Since this is a short plastic procedure , it is usually performed in an out-patient department or private doctor's office and the patient usually can go back home within a few hours after breast implant revision. Sometimes this period before returning home may be longer due to some complications, such as infection, or large capsular contractures. In that case, the patient may have to stay in the hospital overnight.

Recovery after breast implant revision

After surgery, you may feel tired, stiff and swollen. These symptoms should subside soon. The doctor will place a gauze bandage on your breasts in order to provide more support to them. Drainage tubes will be placed in the incision area in order to let the excess fluid outside of the body.
Healing is a gradual process and it takes different time for each individual to recover. It is important for the patient to follow doctor’s instructions carefully. You should try to get as much rest as possible during the recovery period. The doctor should remove the dressing within a few days after surgery. The patient should avoid strenuous exercise and harder physical exertion for at least two weeks. Stitches will be taken out within seven to ten days after surgery.
The patient should be aware that scars will remain pink for two to three weeks. This should change within several months. Your breast will be swollen for some time. Therefore, you should be very patient and aware that final results will be visible only within 3-4 months. Patients usually return to their daily routine within a month, but this is precisely determined by the managing physician.

Breast implant revision side effects

As with all surgery, breast implant revision carries some uncertainty and risk. Complications are not frequent but they still can occur. The most possible complications are infection or hematoma after surgery. Implant rupture or leakage from the implant is also possible. Other complications may include change in sensation of the nipple and breast, capsular contracture, shifting of the breast implant.

Breast revision procedure is very beneficial for women, who want to change the appearance of their breasts or to keep their breast larger and symmetrical. Those who had older silicone implants, are very happy to have them replaced with modern saline-filled ones. These implants have a longer life and, therefore, women do not need additional breast implant revision procedure.
Many patients are very concerned about how long their new placed breast implants will last. This is a hard question and no guarantee can be given. It is very individual but modern breast implants can last decades without changing, and the breasts will still look good. Finally, the cost of such procedure is $3000-$3500.

Breast Augmentation Revision Cost and Financing

Candidates for breast augmentation revision are often concerned about the cost of undergoing a secondary breast surgery. Although breast implant manufacturers guarantee their products for life, the companies do not cover the cost of breast implant revision surgery. Since receiving breast implants is usually an elective cosmetic procedure, insurance plans often do not provide any financial assistance with the cost of correcting complications. However, patients should speak with their insurance provider as many plans offer coverage under certain circumstances. There are also a number of excellent financing options available to manage the medical fees should insurance be inapplicable.

Breast Implant Removal Surgery

Women choose to enhance their breasts for a variety of personal reasons; likewise, there are some who decide to remove their breast implants due to personal and/or medical concerns. If you wish to have your implants removed rather than undergo breast implant revision, learn about breast implant removal surgery.

Breast Implant Replacement Surgery

Whether silicone or saline, breast implants are not built to last a lifetime and eventually need to be replaced. Also, it is not uncommon for women who have had implants for several years to want adjustments made. Breast implant replacement surgery allows surgeons to ensure that a patient’s breasts remain healthy and properly contoured.

Recovery after Breast Augmentation Revision

Although the breast skin and tissue are already accustomed to the presence of implants, recovering from breast augmentation revision is very similar to the recovery experienced after the initial implant surgery. Symptoms such as swelling, soreness, and stiffness are to be expected for the first week or two. Following your surgeon’s post-op instructions and wearing the appropriate compression garments are two keys for maximizing health and minimizing side effects during recovery after breast implant revision.

Breast Augmentation Revision Results and Benefits

The ultimate goal of breast implant revision is to give the patient the balanced, natural-looking bust she desired from the initial surgery. The results of breast augmentation revision vary depending upon the individual, but the majority of patients find that the benefits of breast implant revision make the procedure worthwhile.

Correction Of Inverted Nipples Surgery

2011-03-24T14:17:00.000-07:00

An inverted nipple (occasionally invaginated nipple) is a nipple that, instead of pointing outward, is retracted into the breast. In some cases, the nipple will be temporarily protruded if stimulated, but in others, the inversion remains regardless of stimulus. Women and men can have inverted nipples.
Most people who have inverted nipples are happy to hear about surgical corrections and how simple they can be. Inverted nipple repair is performed on nipples that have been inverted since birth or have become inverted due to breast feeding or other trauma. Recurrence of nipple inversion after surgical repair elsewhere is also a reason that nipple repair may be performed.

Nipple inversion patient before surgery

both in the surgery and the after-care (using the Stevens Stent for traction to ensure the nipple retains eversion), repairs the nipple, retains nipple projection, leaves minimal scarring, and gives a natural appearance.

1 year after surgery

Surgical Correction of Inverted Nipples

Correction for inverted nipples can be done on an out-patient basis. A patient can opt for local anesthesia, intravenous sedation and local anesthesia, or general anesthesia.
The surgery consists of a small incision at the base of the nipple while the nipple is in a protected projected state. Then a gentle spreading of the fibers is performed within the nipple (these fibers are what pulls the nipple inward). Special care is taken: the spreading happens parallel to the milk ducts in order to preserve them.

Nipple base approached via an inferior
periareolar incision

Blunt dissection using a vertical spreading technique parallel
to the ducts

Ductal structures are easily visualized
and preserved

Once the fibers are spread and the nipple is free and in an outward, normal position, special sutures (stitches) are placed inside the nipple. If you think of a clock, the sutures go from the 12:00 position to the 6:00 position. Another set of sutures go from the 3:00 position to the 9:00 position. A third suture goes around the base of the nipple. This adds stability and strength to the base of the nipple and helps retain its outward projection. All sutures are dissolving so you won't be required to come into the office to have any stitches removed.

Two internal 4-0 chromic sutures placed from the twelve to six o'clock and the three to nine o'clock positions

An external 4-0 chromic purse string suture run at the junction of the nipple areola border

The Stevens Stent

Finally a special stent called the Stevens Stent, is placed over the nipple. This stent actually holds your nipple in place and ensures that the nipple heals in an outward position, retaining the integrity gained through the surgery. Not only does it help with the nipples' projection, it also protects the nipple in the healing stages. This stent is left on for one to three days.

A 4-0 Nylon traction suture placed through the center of the nipple

Stents consisting of a medicine cup and gauze padding

The sutures dissolve within 10 to 14 days and the initial incision will not be noticeable. To date, none of the nipples corrected have reverted.
Read more about inverted nipples including the various types and why they occur.
Ready to seek help for your nipples right now? Just go Inside Online and request an appointment with Dr. Stevens or Dr. Stoker. You may be able to save up to $150 on your consultation.
What’s Going On To Cause Inverted Nipples. When your nipple stays in a flat, or even a fully depressed or inverted position you’re typically dealing with a family heredity issue where perhaps your mother or father’s ancestors shared the same breast condition. Alternatively, a small abnormality unique to you occurs… where either scar tissue associated with your milk glands, or bound-up and constricted tissue matter encircling the base of your nipple or areola occurs. Result? An inverted nipple condition occurs. Your nipple is effectively ‘locked down’ into a position, held in place by a matrix of abnormal tissue, even scar tissues in some cases.

Methods of Inverted Nipple Correction

There are numerous choices when it comes to choosing a method of nipple protraction. Discuss which modality is best for your needs with your doctor, as circumstance and physical criteria will influence this decision.Cosmetic nipple surgery can permanently draw out inverted nipples. This operation can cause side effects and complications which might affect nipple function.
Nipple Piercing can be used to retain nipples which can be manually protracted. Nipple rings can cause scar tissue build up and possibly interfere with future breastfeeding ability, although this is rare. The most common complication of nipple piercing is the possibility for infection.
Nipple stretching, such as the Hoffman Technique, may help coax out inverted nipples. These programs may help cosmetically, but also might interfere with the ability to successfully breastfeed.
Nipple Clamps can temporarily protract nipples which can be manually drawn out to begin with.
Nipple pumps and syringes can temporarily protract flat or inverted nipples.
Nipple shields do not protract inverted nipples, but can make breastfeeding easier.

Inverted Nipple Correction Risks

Some methods of drawing out an inverted nipple can influence nipple function and sensation. Any surgical procedure (including piercing) can damage sensitive tissue, reduce sensitivity, prevent nipple arousal and hinder breastfeeding ability. This is also true for some non-surgical techniques, such as manual stretching and overuse of pumps or syringes. Infection is possible from any method which pierces the skin and can result in serious health concerns. Consult with your doctor before choosing any method of correcting an inverted nipple.

Pregnancy and breastfeeding

Women with inverted nipples may find that their nipples protract (come out) temporarily or permanently during pregnancy, or as a result of breastfeeding. Most women with inverted nipples who give birth are able to breastfeed without complication, but inexperienced mothers may experience higher than average pain and soreness when initially attempting to nurse. When a mother uses proper breastfeeding technique, the infant latches onto the areola, not the nipple, so women with inverted nipples are actually able to breastfeed without issue. An infant that latches on well may be able to slush out an inverted nipple. The use of a breast pump or other suction device immediately before a feeding may help to draw out inverted nipples. A hospital grade electric pump may be used for this purpose. Some women also find that using a nipple shield can help facilitate breastfeeding. Frequent stimulation such as sexual intercourse and foreplay (such as nipple sucking) also helps the nipple protract.

Inverted Nipple Correction Via Breast Pump. Breast pumps do more than stimulate lactation and deliver mother’s milk to your baby. That same suctioning power of the breast pump can be applied during non-feeding times, or for women not pregnant, in an action designed to firmly distend your nipple and help you break-up the offending interior adhesions.

Typical Minimum Cost of Inverted Nipple (based on national averages):
$1,000.00Typical Maximum Cost of Inverted Nipple (based on national averages):
$4,000.00 National Average Cost of Inverted Nipple:
$2,500.00 Time Required for Inverted Nipple:
The time required to perform the surgery varies, but 1-2 hours is typical. Is Inverted Nipple an InPatient or OutPatient Procedure?
In most cases, inverted nipple correction surgery is performed on an outpatient basis, but in certain instances, the patient may be asked to stay overnight. What are the Side Effects of Inverted Nipple?
Patients may exprience pain, swelling and sensitivity in their nipple area for a up to two weeks following surgery. How Long do Inverted Nipple results last?
Results from this surgery are permanent.What is the recovery time for Inverted Nipple?
Recovery time varies based on the particulars of the patient. Typically patients can move around immediately following surgery but they should be driven home and will typically be encouraged to stay in bed for 2 days after the surgery. Work can usually be resumed a week after the treatment. What types of anesthesia is necessary for Inverted Nipple?
Local anesthesia is usually employed but in certain cases general anesthesia may be required.

Breast Asymmetry Correction Surgery

2011-03-24T10:46:00.000-07:00

Breast asymmetry

Breast asymmetry surgery information and procedures. Find a plastic surgeon in your area who specializes in breast asymmetry surgery.

Most people have slightly different-sized -- or asymmetrical -- breasts. However, in some cases the difference in size is pronounced. In these cases, correction is often desired. The best procedure will depend on several factors, including how you want to balance the breasts. You may want to augment (enlarge) the smaller breast to look like the larger one, or reduce the size of the larger breast to match the smaller one. Both breast augmentation and reduction are widely performed procedures. If you're considering augmentation or reduction to correct breast asymmetry, the following information will provide you with a good introduction to the procedures involved. For even more information, you may want to read through our breast augmentation and breast reduction procedure descriptions. For more detailed information about how these procedures may help you, we recommend that you consult a plastic surgeon who is board certified or has completed a residency program that includes instruction in these procedures.

What are the most common benefits of this surgery?

Improved balance in size and shape
Greater ease in finding clothing that fits evenly across the chest
Improved sense of comfort, particularly in body-conscious clothing

What will happen at the initial consultation?
During the initial consultation, you and your surgeon will discuss the changes that you would like to make in your appearance. He/she will explain the different options available to you, the procedure itself, and its risks and limitations. He/she will also explain the kind of anesthesia required, surgical facility, and costs.
Your surgeon will begin with a complete medical history. He/she may also give you specific instructions preparing for surgery, including guidelines for eating and drinking, smoking, and taking or avoiding vitamins, supplements and medications.
Take this opportunity to ask all the questions you have about the surgery. Ask for, and follow up on, patient references. Learning everything you can about your options, risks and benefits is the key to making an informed decision. See Questions to ask your doctor below.
How is asymmetry correction performed?
Asymmetrical breasts can be made more even either by augmentation of the smaller bust, or by reduction of the larger one:
Augmentation: In this procedure, the surgeon makes an incision either under the armpit, in the crease under the breast, around the areola (the pigmented tissue around the nipple), or through the navel. The surgeon then lifts the breast tissue, creates a pocket in the chest area ? either above or below the muscle, and then places the implant inside the pocket. Almost all implants used today are filled with a saline solution.
Reduction: In this procedure, an anchor-shaped incision is made on the breast itself. The excess fat tissue removed in a liposuction-type procedure, and then the incision is closed, creating a contour closer in size and shape to the other one. If less tissue will be removed, a doughnut-shaped area of skin may be removed just around the nipple. An advantage to this procedure is that the incision and stitches may be less visible.
How long does the surgery take?
The length of the plastic surgery procedure depends on the type of procedure you choose, your anatomy, the incision technique, and type of anesthesia.
Will I have to stay in the hospital?
Maybe. The location chosen for the surgery depends on the procedure performed and the extent of the work being performed. Most breast augmentation and reduction surgeries are performed in a surgical suite as an outpatient procedure. In this case, you?ll be able to return home within a few hours of the surgery. However, if large amounts of tissue are removed during a reduction procedure, your doctor may want you to stay overnight in the hospital where medical personnel can monitor your initial recovery.
How much pain is there?
Augmentation: Breast augmentation stretches the tissues, and can be painful. This is especially true when the implants are placed under the muscle, and in young women who have never had children. The pain is greatest within the first 48 hours, but improves with each day and is somewhat relieved by pain medications. In spite of the initial discomfort, most women report that they are very satisfied with the results of the surgery.
When you wake up you will feel tired, sore, and stiff. It is important to take the medication prescribed to you by your doctor. You?ll need someone to drive you home, and you may need assistance at home over the next couple of days.
Your surgeon may prescribe an antibiotic and an anti-inflammatory medication to be taken after the surgery. It is a good idea to have these prescriptions filled beforehand.
Reduction: Although the surgical incision for this surgery is quite large, it is placed in areas of the breast that are not very sensitive. Thus, the pain after surgery is usually easily managed with a pain reliever. Initially, there is discomfort in walking, getting out of bed, and any activity that causes the chest to move. You may continue be sore for the first few days after surgery.
What can I expect after surgery?
Your breasts will be wrapped with gauze bandage, plus a tighter bandage for protection and support. You also may have small drainage tubes coming out of the incisions, to help drain some of the excess fluid.
It is important to take the medication prescribed to you by your doctor. Someone will need to drive you home, and you may need assistance at home over the next couple of days.
If your skin is very dry following surgery, you can apply a moisturizer, but be sure to keep the suture (stitches) area dry.
What is the recovery period like?
You will receive instructions about changing the gauze and keeping the incisions clean, positions for sleep and rest, raising your arms, breathing exercises and massage.
Whether you choose augmentation or reduction, you should:

Expect to feel tired and tender for the first 24 to 48 hours. Your breasts will be bruised and sore?be prepared to take it easy.
Drink plenty of fluids and be sure to follow your medication schedule.
Allow enough time for recovery. If your job is not too physically demanding, you?ll probably be able to go back to work in a week or so. If your work requires physical energy and stamina, you?ll need to allow more time for your recovery.
Avoid vigorous or strenuous exercise for six weeks.
Know what to expect. Your stitches will be removed in a week to 10 days. The incision scars will be firm and pink for at least six weeks, and then will begin to fade. Your breasts will remain swollen for three to four weeks following surgery. They will be tender to touch and movement.
Avoid lifting and pushing for two weeks--no heavy lifting or pushing for four weeks.
Allow about two months for complete recovery.

Discomfort following surgery (which lessens and disappears over time) is expected; however, be sure to tell your doctor if:

There is an increase in pain, swelling, redness, drainage or bleeding in the surgical area;
You develop headache, muscle aches, dizziness or a general ill feeling and fever, nausea or vomiting.

These can be symptoms of infection, and may require medical attention. The usual follow ups after surgery are at one week, one month, three and/or six months, and thereafter at annual exams.
What is the long-term outcome like for most people?
Correction to breast asymmetry can help clothes to fit better as well as improve the overall silhouette by balancing the breast contours. Remember, though, that as with breasts in general, the pull of gravity will affect a surgically corrected breast over time. However, since the breasts are now more equal in size and weight, they may undergo such changes more evenly.

Ideal candidate:
In general, the best candidates for asymmetrical breast correction are:

18 years of age or older
Not currently pregnant or nursing
In good physical health
Psychologically stable
Wanting to improve their appearance
Realistic in their expectations
Having this surgery for the first time

In addition, the candidate for reduction surgery also should understand that scarring on the breast, although diminishing over time, will be permanent.
The above is only a partial list of the criteria that your surgeon will consider in determining whether or not breast augmentation or reduction is appropriate for you. Be sure to ask your surgeon if he / she considers you an ideal candidate for a breast augmentation or reduction in order to improve symmetry.
Risks and limitations

All operations carry some risk and the possibility of complications can include (but are not limited to) infection, unsatisfactory results, excessive bleeding, adverse reaction to anesthesia, and the need for second or sometimes third procedures. In addition, the following should be noted with regard to augmentation and reduction in particular:
Augmentation: There are several concerns regarding breast augmentation: the surgery itself, the implants, breast cancer, and the risk of anesthesia. The risks involved with breast augmentation have received a lot of attention, but it is very unlikely that you would get breast cancer or arthritis solely caused by the breast implants. We recommend you read the specific complications outlined in the "Food and Drug Administration Infomation for Women Considering Saline-Filled Breast Implants" (courtesy of McGhan Medical Corporation and FDA). To obtain this information, contact the McGhan Medical Corporation, F.D.A. Consumer Information Line at (800) 532-4440 or your surgeon. There is no known association of breast implants with breast cancer in human beings, and in fact several large studies have shown a lower incidence of breast cancer in women with breast implants. (Breast implant type devices have been shown to cause a rare form of cancer in rats that are prone to cancer, but this cancer has not been reported in humans with breast implants.)
Other side effects specific to breast augmentation include:

capsular contracture, which occurs when the scar or area around the implant begins to tighten, causing the breast to feel hard.
nipple sensitivity or loss in sensitivity. This usually disappears after several weeks, but for some may be permanent.
rippling: indentations on the breast, often caused when the implant moves.
rupture: when the breast implants tear and/or leak. This may require a second operation to replace the implant.
symptoms of immune system disorders: some women have reported having symptoms such as joint pain swelling, fever, fatigue, or breast pain. Although research has not found conclusive evidence correlating breast implants with these symptoms, the FDA has requested that further study be done on this subject.

Many times patients will not be aware of complications until days or months after the procedure has been performed.
Reduction: In this surgery, serious complications are quite rare, but there is often significant blood loss due to the magnitude of the surgery. In addition, small areas of infection are not uncommon; nor is delayed healing in areas of the incisions. There is also a possibility of developing small sores around the nipples, which can be treated with antibiotic creams. If you carefully follow all your surgeon?s instructions both before and after the surgery, you can minimize the risks.
As mentioned previously, future breast-feeding may not be possible, since the surgery removes many of the milk ducts leading to the nipples. Some patients may experience a permanent loss of feeling in the nipple or breast after reduction. Rarely, the nipple and areola may lose their blood supply, and the tissue dies
Costs
Costs for these procedures vary, depending on the doctor, the location, technique used and the difficulty of the specific case. Reported costs apply to surgery involving both breasts: ask your doctor about differences in cost where only one breast is corrected.
The fees listed below do not include anesthesia, operating room facility, hospital stay and other related expenses.
Augmentation: The national average of 1999 surgeon fees for augmentation was $3,142 (Source: The American Society of Aesthetic Plastic Surgery). Regional averages: New England states: $3,949; middle Atlantic states: $2,820; north central states: $2,936; south central states: $2,739; and mountain/Pacific states: $3,248. In most cases, health insurance policies do not cover the cost of augmentation.
Reduction: The national average of 1999 surgeon fees for reduction was $5,024 (Source: The American Society of Aesthetic Plastic Surgery). Regional averages: New England states: $5,789; middle Atlantic states: $4,771; north central states: $5,196; south central states: $4,789; and mountain/Pacific states: $4,689. You should ask your surgeon if your needs are medically indicated, in which cast the costs may be covered by your medical insurance.
How do I finance this procedure?
Did you know that 29% of all Americans have considered having an elective procedure? Of those, 60% would schedule a procedure immediately if financing was available. With iEnhance's patient financing options, money no longer has to be the barrier between you and your new image. By filling out our on-line application you can qualify for a loan in as little as 30 seconds.

Male Chest Reconstruction Surgery

2011-03-24T06:04:00.000-07:00

In men with female breast growth, caused either by gynecomastia or by status as a transman, a male chest reconstruction is often done to give the chest a more masculine appearance. In transgender and transsexual people, this surgery may be performed as part of the transition of a female body into a male/masculine body.

Breast augmentation

Male chest reconstruction usually precedes genital surgery for transmen, as protruding breast contours are a secondary female sexual characteristic.
While for very small breasts a peri-areolar skin excision can be performed, the problem of maintaining an adequate pedicle to support the nipple areolar complex without protrusion of the pedicle through the skin becomes challenging. Bringing skin into the borders of a contracted areola will cause puckering which hopefully with time will smooth out. A permanent fixation suture is often required to prevent tension on the suture line from causing a slowly expanding scar.

Inverted "T" procedure

A transverse inframammary incision with free nipple areolar grafts may be one approach. If there is too much blousing of the skin, the alternatives are to extend the incision laterally (chasing a dog ear) or to make a vertical midline incision (inverted T).
The areola is trimmed to a pre-agreed-upon diameter and the nipple sectioned with a pie-shaped excision and reconstituted. There may be varying sensory loss because of nerve disruption.

Nipple grafts

Keyhole procedure

To remove the glandular and fatty tissue which comprise the breast mass and the added skin that drapes the mass, there are three basic approaches.
For petite breasts, like an A or a small B, a peri-areolar incision can be done. That is a circular incision around the areola, combined with an inner circular incision to remove some of the unneeded areola as well. Drawing the skin into the center will result in some puckering, but this often smooths out with time. There will be significant tension on the scar line, and to prevent spreading of the scar, a permanent fixation suture is needed. Leaving outer dermis (raw skin) underneath the marginalized areola helps in its survival.
The keyhole incision (think skeleton key) augments the periareolar incision further by making a vertical closure underneath (lollipop), which results after the unwanted skin is pulled in from side to side and the excess is removed.
An anchor incision adds to that a transverse incision usually in the infra mammary fold to further remove excessive skin. Draping or blousing is not desirable. This is reserved for much larger breasts or topographically a larger surface area as seen in women with postpartum breast atrophy.

"Dog ear"

Occasionally the side limbs may be quite long, and the expression doctors use is "chasing a dog ear" into the axilla (or underarm). A dog ear is an unpleasant ruffle of skin in the corner of an incision when there is too much gathering usually at an angle greater than 30 degrees.
Not uncommonly the surgeon may wish to revise the incision lines after 3 or more months of settling shows some residual problem areas.
The nipple areolar complex may be supported by a pedicle which has the advantage of leaving some sensation and blood supply intact, but can have the disadvantage when the pedicle has sufficient bulk not to provide the flat look most FTM patients desire.

Areola graft

The use of a free and reduced nipple areola graft allows the masculine-looking graft to be placed precisely where it should be, best seen by sitting the patient up on the table while under anesthesia. The disadvantage is perhaps at times some predisposition to a partial take or failure for the graft to take at all.
There are many techniques to reconstruct a nipple as well as tattoo the areolar area should that be necessary.

Male Chest Reconstruction

Male Chest Reconstruction usually precedes below the waist surgery for FTM patients as protruding breast contours are a sin qua non of the female presentation.

While for very small breasts a peri-areolar skin excision can be performed, the problem of maintaining an adequate pedicle to support the nipple areolar complex without protrusion of the pedicle through the skin becomes challenging. Bringing skin into the borders of a contracted areola will cause puckering which hopefully with time will smooth out. A permanent fixation suture is often required to prevent tension on the suture line from causing a slowly expanding scar.

A transverse inframammary incision with free nipple areolar grafts is my preferred approach. If there is too much blousing of the skin, the alternatives are to extend the incision laterally (chasing a dog ear) or to make a vertical midline incision (inverted T).

The areola is trimmed to a pre agreed upon diameter and the nipple sectioned with a pie shaped excision and reconstituted.

Although the patient must be cautioned there may be varying sensory loss because of nerve disruption, our limited experience has been favorable in this regard as distal nerves are known to regenerate.

Nipple areolar grafts must be kept wet with saline soaked gauze re-moistened every 3 hours for at least 5 days to maintain tissue viability until capillary buds grow into the graft.

Plan on having a roommate or spouse do this for you throughout the night.

Some crusting of the grafts is not unusual and will usually shed by the 3 or 4th week. By all means do not lift or pick them off as the adherence of the graft may be very tenuous and its viability very fragile.

After tissue settling some revision surgery may be required and is usually done for a nominal fee relating only to use of the facility and anesthetic services if required (as opposed to being done under local).

Breast sizes greater than a C, need to be done in hospital setting.

Fee $5,000 to $8,500 for male chest reconstruction surgery.

Male Breast Reduction or Gynecomastia Surgery

2011-03-24T05:37:00.000-07:00

Gynecomastia
What is Gynecomastia? Gynecomastia refers to the condition where males develop abnormally large breasts. Besides being uncomfortable and self conscious about one's condition, symptoms can even include milk secretion. What causes Gynecomastia is still uncertain, but it is generally linked to an imbalance in hormones or the tissues related to them.

Gynecomastia is not physically harmful to the patient, but it’s an embarrassment that doesn’t have to be. Gynecomastia can be cured. Gynecomastia surgery, or male breast reduction, reduces breasts that are femininely oversized and sagging.

There are those who choose to live with Gynecomastia by hiding behind compression garments, but there are real solutions to end Gynecomastia. Natural weight loss and hormone therapy are great options to help stop the root cause, but they can leave you with sagging breast tissue and a drooping chest. The best Gynecomastia treatment to eliminate male breasts is surgery. Through liposuction or more invasive surgical methods, excess tissue, fat, and skin are removed to create a more attractive and masculine chest contour.
FAQs

Typical Minimum Cost of Gynecomastia:
USA $3,650.00 India $1215.00

Typical Maximum Cost of Gynecomastia:
USA $6,625.00 India $ 2208.00

Average Cost of Gynecomastia:
USA $5,137.50 India $1712.00

Time Required for Gynecomastia:
It usually takes about 1-2 hours to perform Gynecomastia surgery. Time requirements do vary depending on the extent of surgery.

Is Gynecomastia an InPatient or OutPatient Procedure?
Outpatient.

What are the Side Effects of Gynecomastia?
Gynecomastia surgery side effects can include temporary swelling, bruising, and tenderness.

How Long do Gynecomastia results last?
Gynecomastia surgical results are permanent, but subject to changes in appearance as the patient's weight fluctuates.

What is the recovery time for Gynecomastia?
Day 1-14 After gynecomastia surgery, recovery from swelling usually takes at least 1-2 weeks. The patient usually wears a compression wrapping around the chest for those first couple weeks to help the swelling go down.

Day 2 Many patients return to work as quickly as 1-2 days after surgery.

Day 7 Sutures can usually be removed about 7-10 days into gynecomastia recovery.

Please Note**It is usually required that at least 3 weeks be given before patients pursue exercise or other more strenuous activity.

Will my insurance company cover Gynecomastia?
Because of the normally cosmetic nature of Gynecomastia surgery, insurance is usually not involved. However, in some circumstances, it may be deemed necessary to have male breast reduction surgery. Insurance would then cover a portion or possibly all of the cost, depending on your provider.

Is there much discomfort for Gynecomastia?
Gynecomastia pain and discomfort is very minimal, and very easily controlled with oral pain medication.

What types of anesthesia is necessary for Gynecomastia?
The Gynecomastia surgery anesthesia of choice is usually general, though local anesthesia with sedation may also be opted for.

What else can I combine Gynecomastia with?
For enhanced results, Gynecomastia surgery may be combined with:

Liposuction
Tummy Tuck
Facial Implants

What else is Gynecomastia referred to as?
Male Breast Reduction. Getting rid of man boobs (slang).

The Gynecomastia Surgery Procedure

If your enlarged breasts consist primarily of excessive fatty tissue, your surgeon may use liposuction. If excess glandular tissue is the primary cause, the tissue may be cut out with a scalpel. This excision may be performed alone or in conjunction with liposuction.
During an excision procedure, the incision is made either on the edge of the nipple (areola) or in the underarm area. The surgeon cuts away the excess glandular tissue, fat and skin from around the pigmented area surrounding the areola and from the sides and bottom of the breast by working through the incision. Major reductions that involve the removal of a significant amount of tissue and skin may require larger incisions and more visible scars.
If liposuction is also used to remove excess fat, a slim, hollow tube (cannula), is inserted directly through the existing incisions. The cannula is attached to a vacuum pump to suction out the fat.
For liposuction-only breast reduction, your surgeon will likely make a small incision of less than a half-inch in length around the edge of the areola. Or he or she may make the incision in the underarm area. You may feel a vibration or some friction during the procedure, but generally no pain.
Sometimes a small drain is inserted through a separate incision to remove excess fluids. Once closed, the incisions are covered with a dressing. The chest may be wrapped to keep the skin firmly in place.
Breast reduction surgery for gynecomastia is most often performed on an outpatient basis, in an office-based or ambulatory surgical facility or in the hospital. Sometimes an overnight hospital stay is recommended. Time in surgery is typically an hour and a half, but a more extensive male breast reduction may take longer.
The procedure may be performed under general anesthesia or local anesthesia with sedation. Your surgeon will discuss your anesthesia options with you once you have decided on surgery.

Risks of Gynecomastia Surgery

Surgical risks include:

Scarring
Swelling
Bruising
Bleeding
Blood clots
Infection
Poor wound healing
Temporary or permanent changes in nipple or breast sensation
Anesthesia risks
Breast contour and shape irregularities
Skin discoloration
Permanent pigmentation changes
Damage to the nerves, blood vessels, muscles and lungs
Allergies to surgical materials
Breast asymmetry
Fatty tissue found deep in the skin might die (this is called fat necrosis)
Fluid accumulation
Deep vein thrombosis
Cardiac and pulmonary complications
Pain
Possibility of revision surgery for additional tightening or repositioning of the breasts
Death

Risks of liposuction for gynecomastia include:

Uneven contours
Rippling or loose skin
Irregular pigmentation
Excessive fluid loss
Fluid accumulation
Infection
Blood clots in the lung (pulmonary emboli)
Hematoma (a collection of blood in the areas suctioned)
Temporary numbness or discoloration in the treated area
Asymmetry, dimpling, wrinkling, unevenness and surface irregularities over the treated area
Perforation wounds in surrounding tissue or organs
Anesthesia reactions
Swelling
Burns (from ultrasound-assisted and laser-assisted liposuction)
Death

Recovering From the Surgery

Have someone drive you after surgery and help you at home for a day or two if needed. Whether you've had liposuction, excision with a scalpel or both for your gynecomastia, you will feel discomfort for a few days. The pain can be managed with a prescription from your doctor.
To help reduce swelling, you'll probably need to wear an elastic pressure garment continuously for a week or two, and for a few weeks longer at night. Although the worst of the swelling will subside in the first few weeks, it may be three months or more before the final results of your surgery are apparent.
You'll be encouraged to begin walking around on the day of surgery, and to return to work when you feel well enough, which could be in a couple of days. Stitches are removed one to two weeks after the procedure.
Your surgeon may advise you to avoid sexual activity for a week or two and heavy exercise for about three weeks. You will be told to stay away from any sport or job that risks a blow to the chest area for at least four weeks. Your activities should be back to normal after about a month.
It's important to avoid exposing surgical scars to the sun for at least six months. Sunlight can affect the skin's pigmentation permanently, causing the scar to turn dark. If sun exposure is unavoidable, use a strong sunblock.
If you experience shortness of breath, chest pains, or unusual heart beats after the procedure, contact your surgeon immediately. These complications may require hospitalization and additional treatment.

Cost of Gynecomastia Surgery

The cost of male breast reduction typically includes the surgeon's fee, hospital or surgical facility costs, anesthesia fees and prescriptions for medication and post-surgery garments. According to statistics from both the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons, the national average for plastic surgeon fees for gynecomastia surgery is roughly $3,400.
In most cases, the cost of male breast reduction surgery is not covered by insurance. But each insurance policy varies greatly, so review your policy carefully to determine coverage. The ASPS has published a position paper for physicians and insurers defining the recommended criteria for coverage of reconstructive cases. This document grades the condition based on its severity, the length of time it has been present and the symptoms that it is causing in both adults and teens.
The ASPS states that male breast reduction surgery should be covered by insurers when it is performed to relieve symptoms or signs of deformity related to excessive breast size. Ask your physician for a copy or of this document to submit to your insurer or view the online version.
Many plastic surgeons offer patient financing plans, so be sure to ask.

Breast Removal Surgery

2011-03-22T14:08:00.000-07:00

In medicine, mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. Mastectomy is usually done to treat breast cancer; in some cases, women and some men believed to be at high risk of breast cancer have the operation prophylactically, that is, to prevent cancer rather than treat it. It is also the medical procedure carried out to remove breast cancer tissue in males. Alternatively, certain patients can choose to have a wide local excision, also known as a lumpectomy, an operation in which a small volume of breast tissue containing the tumor and some surrounding healthy tissue is removed to conserve the breast. Both mastectomy and lumpectomy are what are referred to as "local therapies" for breast cancer, targeting the area of the tumor, as opposed to systemic therapies such as chemotherapy, hormonal therapy, or immunotherapy.
Traditionally, in the case of breast cancer, the whole breast was removed. Currently the decision to do the mastectomy is based on various factors including breast size, number of lesions, biologic aggressiveness of a breast cancer, the availability of adjuvant radiation, and the willingness of the patient to accept higher rates of tumor recurrences after lumpectomy and radiation. Outcome studies comparing mastectomy to lumpectomy with radiation have suggested that routine radical mastectomy surgeries will not always prevent later distant secondary tumors arising from micro-metastases prior to discovery, diagnosis, and operation.

Rates

Mastectomy rates vary tremendously worldwide, as was documented by the 2004 'Intergroup Exemestane Study', an analysis of surgical techniques used in an international trial of adjuvant treatment among 4,700 women with early breast cancer in 37 countries. The mastectomy rate was highest in central and eastern Europe at 77%. The USA had the second highest rate of mastectomy with 56%, western and northern Europe averaged 46%, southern Europe 42% and Australia and New Zealand 34%.

Mastectomy indications

Despite the increased ability to offer breast-conservation techniques to patients with breast cancer, there exist certain groups who may be better served by traditional mastectomy procedures including:

women who have already had radiation therapy to the affected breast
women with 2 or more areas of cancer in the same breast that are too far apart to be removed through 1 surgical incision, while keeping the appearance of the breast satisfactory
women whose initial lumpectomy along with (one or more) re-excisions has not completely removed the cancer
women with certain serious connective tissue diseases such as scleroderma, which make them especially sensitive to the side effects of radiation therapy
pregnant women who would require radiation while still pregnant (risking harm to the fetus)
women with a tumor larger than 5 cm (2 inches) that doesn't shrink very much with neoadjuvant chemotherapy
women with a cancer that is large relative to her breast size
Women who have tested positive for a deleterious mutation on the BRCA1 or BRCA2 gene and opt for prophylactic removal of the breasts
male breast cancer patients

Types of mastectomy

There are a variety of types of mastectomy in use, and the type that a patient decides to undergo (or whether he or she will decide instead to have a lumpectomy) depends on factors such as size, location, and behavior of the tumor (if there is one), whether or not the surgery is prophylactic, and whether or not the patient intends to undergo reconstructive surgery.

Simple mastectomy (or "total mastectomy"): In this procedure, the entire breast tissue is removed, but axillary contents are undisturbed. Sometimes the "sentinel lymph node"--that is, the first axillary lymph node that the metastasizing cancer cells would be expected to drain into—is removed. This surgery is sometimes done bilaterally (on both breasts) on patients who wish to undergo mastectomy as a cancer-preventative measure. Patients who undergo simple mastectomy can usually leave the hospital after a brief stay. Frequently, a drainage tube is inserted during surgery in their chest and attached to a small suction device to remove subcutaneous fluid. These are usually removed several days after surgery as drainage decrease to less than 20-30 ml per day.
Modified radical mastectomy: The entire breast tissue is removed along with the axillary contents (fatty tissue and lymph nodes). In contrast to a radical mastectomy, the pectoral muscles are spared.
Radical mastectomy (or "Halsted mastectomy"): First performed in 1882, this procedure involves removing the entire breast, the axillary lymph nodes, and the pectoralis major and minor muscles behind the breast. This procedure is more disfiguring than a modified radical mastectomy and provides no survival benefit for most tumors. This operation is now reserved for tumors involving the pectoralis major muscle or recurrent breast cancer involving the chest wall.
Skin-sparing mastectomy: In this surgery, the breast tissue is removed through a conservative incision made around the areola (the dark part surrounding the nipple). The increased amount of skin preserved as compared to traditional mastecomy resections serves to facilitate breast reconstruction procedures. Patients with cancers that involve the skin, such as inflammatory cancer, are not candidates for skin-sparing mastectomy.
Nipple-sparing/subcutaneous mastectomy: Breast tissue is removed, but the nipple-areola complex is preserved. This procedure was historically done only prophylactically or with mastecomy for benign disease over fear of increased cancer development in retained areolar ductal tissue. Recent series suggest that it may be an oncologically sound procedure for tumors not in the subareolar position.

History

Mastectomy for breast cancer was performed at least as early as 548 A.D., when it was proposed by the court physician Aetios of Amida to Theodora. She declined the surgery, and died a few months later.

What are the risks?

Mastectomy is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

Side-effects

These are the unwanted, but mostly temporary effects of a successful treatment, for example feeling sick as a result of the general anaesthetic.
Side-effects of a mastectomy include:

soreness, swelling, bruising and tightness in your breast area and in your arm and shoulder
scarring - you will have a permanent scar, this usually fades over time
numbness and tingling in your upper arm

Complications

This is when problems occur during or after the operation. Most women aren't affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
Complications of mastectomy are uncommon, but can include:

infection - antibiotics may be needed
build up of fluid around the healing wound (seroma) - this may require further surgery
change in sensation in the operated area - this can be permanent
unusual red or raised scars (keloids) - these can take years to improve

If you have lymph nodes removed from under your arm in the same procedure, there is a risk of having a build up of fluid in your arm (lymphoedema). This causes swelling, pain and tenderness in your arm and hand and may require further treatment.
The exact risks are specific to you and will differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.

What happens during mastectomy

Depending on the type of mastectomy you have, your operation may take up to two hours.
The technique your surgeon will use will depend on the type of mastectomy you are having.
In a simple mastectomy, a diagonal or horizontal cut is made across the breast, and the breast tissue is removed.
Your surgeon may do a sentinel lymph node biopsy and remove lymph nodes from under your armpit through the same cut.
A breast reconstruction may be done at the same time as the mastectomy or at a later date, or not at all.
When the operation is complete, the cuts are closed with stitches (which may be dissolvable).
Fine plastic tubes may be left in your breast area for up to 48 hours afterwards. These allow blood and fluids to drain into a bag.

Breast Implants / Boob Job Surgery

2011-03-22T13:13:00.000-07:00

A breast implant is a prosthesis used to alter the size, form, and feel of a woman’s breasts in post–mastectomy breast reconstruction; for correcting chest wall congenital deformities; for the aesthetic enhancement of the bust; and as a procedural aspect of male-to-female gender transition surgery. There are three general types of breast implant devices defined by their filler material: saline, silicone, and composite (alternative composition). The saline implant has an elastomer silicone shell filled with sterile saline solution, the silicone implant has an elastomer silicone shell filled with viscous silicone gel, and the alternative composition implants featured miscellaneous fillers, such as soy oil and polypropylene string, et cetera. The pectoral implant is the male breast implant device for reconstructive and aesthetic enhancement of a man’s chest wall, (see mastopexy). In breast reconstruction surgery, the breast tissue expander implant is a temporary breast-implant device used in staged breast reconstruction.

What You Need to Know About Breast Implants

Breast implants give you more control over your size, shape, and profile. Implant plastic surgery can improve appearance after aging and childbearing and can restore a more youthful appearance.
(Note that sagging breasts require a breast lift, which can be performed with or without implants.)
In breast augmentation with implants (augmentation mammoplasty), the implants are inserted behind breast tissue or above the breast muscle. Implants range in volume from 120 mL (milliliters) to 850 mL. You can view examples in our breast augmentation before-and-after photos.
In addition to the volume range, implants vary in shape, profile, outer thickness, and outer surface layer.
Read more about implant anatomy.
An alternative to traditional implants is fat grafting breast augmentation, which involves harvesting fat by liposuction from an area of your body where you have plenty. The fat cells are then processed and injected into the breasts. It can also be used to even out any imperfections left behind after breast augmentation with implants or breast reconstruction.

Silicone Implants

Some women feel that silicone implants are smoother and softer than saline-filled implants. These implants feel like a semisolid gel. Because of their smooth surface, silicone implants are often preferable for women who have little breast tissue, particularly for women undergoing breast reconstruction.
The U.S. Food and Drug Administration (FDA) removed silicone implants from the general consumer market in 1992 as a precautionary measure over conflicting reports of possible complications, some of which required breast implant removal. However, they were reapproved in 2005. (Read more about implants and the FDA.)
Options under development include cohesive silicone gel implants — also called gummy bear implants — and saline implants that allow implant volume to be adjusted after surgery. Cohesive implants are currently under FDA review. They are claimed to hold their shape better than saline or older silicone gel implants and look and feel more natural. The gummy consistency decreases the likelihood of rippling and should provide greater safety because, being more solid, the silicone will tend not to escape from the shell if it were to rupture.

Procedure

Depending on the patient and the desired outcome, breast augmentation surgery can be a very simple or very complex procedure.

After pre-operative preparation, the surgery starts by cutting one incision into the patient for each implant. The incisions are small and placed so that the scarring is minimal and hard to see. Once the incision is created, the surgeon must cut a path through the tissue to the final destination of the implant. Once that path has been created, the tissue and/or muscle (depending on placement) must be separated to create a pocket for the implant. This is where the surgeon's skill really comes into play: When deciding where to cut the pocket in the breast, the surgeon must predict what the breasts will look like once the implants are filled. In more extreme augmentation surgeries, this involves repositioning the nipple, adjusting for cleavage and creating a new crease under the breast.
In some cases, augmentation surgery is accompanied by mastopexy (breast lift) surgery so that everything ends up in the right place. To aid in positioning, the surgeon may decide to use a sizer or disposable implant. Sizers are temporary implants attached to a tube that the surgeon can work inside the pocket and fill up to test placement, implant size and fill levels. Once this has been tested, the sizer is removed and replaced with the permanent implant.
When inflatable implants are used, they are rolled up like a cigar and pushed into the incision, through the channel and into place. This is true no matter which type of incision is used (we'll talk about incisions in the following sections). Once the implant is positioned, the incision is closed. In the last step, the surgeon uses a syringe to fill the implant with saline through the valve, filling it to the predetermined size.
If the patient has opted to use pre-filled implants, the incision will be larger. Inserting textured, pre-filled implants requires the longest incision, providing more room for inserting an implant with a rough shell and for manipulating the less-pliable implant once it's in place.
Plastic surgeons can use one of four different types of incisions to insert the implant into the breast: peri-areolar, inframammary fold, transaxillary, and TUBA. In the next sections, we will learn the difference between these types of incision.

Risks

Risks associated with this procedure are similar to those of any surgical procedure. These risks include bleeding, infection, reaction to anesthesia, or unexpected scarring. A breast enlargement may also result in decreased sensation in the breast or interference with breastfeeding. Implants can also make it more difficult to read and interpret mammograms, possibly delaying breast cancer detection. Also, the implant itself can rupture and leak, or become displaced. A thick scar that normally forms around the implant, called a capsule, can become very hard. This is called capsular contracture, and may result in pain and possible altered appearance of the breast. The chances that these problems will occur increase with the age of the implant.
There has been intermittent publicity about possible health risks associated with breast implants. Most concerns have focused on silicone gel-filled implants that leaked or ruptured. In 1992, the Food and Drug Administration (FDA) restricted the use of this type of implant and ordered further studies. Today only saline-filled implants are used for cosmetic breast surgery. Recent studies have shown no evidence of long-term health risks from intact silicone implants. However, research on possible links between these implants and autoimmune or connective tissue diseases is continuing.

Aftercare

Many normal activities such as driving may be restricted for up to one week. Sutures are usually removed in seven to 10 days. Typically, a woman can resume all routines, including vigorous exercise , in about three weeks. The scars will be red for approximately one month, but will fade to their final appearance within one to two years.

Type of Breast Implants
The cost also counts on what type of breast augmentation and implant procedure you choose. There are two types of procedures; saline-filled implants and silicone-filled implants. The first one is a bit more inexpensive than the latter procedure. Normally, saline-filled implants may cost you around $3,500, whereas silicone-filled implants can cost you approximately $4,500. If the surgery has to be done on small breasts, the cost might be lower, and vice versa. There also may be some additional procedures required to be done, which may add up to the overall cost.
Average Cost of Breast Implants
The typical cost of breast implants may include the anesthesia cost which ranges from $600 to $800, the breast augmentation and implant procedure charges which range from $1,000 and $1,300, the operating surgeon's service charges which may range from $3,000 to $4,000, and lastly, other miscellaneous expenses which may arise due to complications during the procedure. With all the above considerations, the average cost of breast implants may go up to $8,000-$9,000.

Breast Implant Shapes

Round and teardrop breast implants are the two implant shapes used for breast enlargement. Many women select round breast implants because they add the most lift and proportion. However, more and more women are choosing teardrop-shaped implants, also known as contoured breast implants, because these women desire breast enlargement that looks as natural as possible. Learn more about breast implant shapes and how they are used to augment breast shape and size.

Breast Implant Textures

The surface texture of breast implants can be either smooth or textured. Smooth-surfaced breast implants are used in most breast enlargement surgeries because they are softer, have a reduced risk of rippling, and cost less than textured implants. However, the sandpaper-like surface of textured breast implants helps maintain vertical alignment, a desired trait for breast enlargement with teardrop-shaped implants. Learn more about the different breast implant textures and their advantages and disadvantages.

Breast Implant Sizes

Breast implants are available in a variety sizes, from small (125cc) to very large (1200cc). Women who desire a perky, more youthful breast contour are better served by choosing a more conservative implant size. Women whose primary objective is breast enlargement will achieve the best results with larger breast implants. Learn about small breast implants and large breast implants and how different sizes help women achieve their breast enhancement goals.

Breast Implant Types

An FDA moratorium on silicone breast implants instituted in 1992 caused saline implants to be used almost exclusively for breast enlargement procedures in the United States for many years. However, in November 2006 the FDA once again allowed silicone breast implants for general use. Cohesive silicone gel implants have not yet been approved for general use by the FDA, but clinical trials are currently being conducted to determine their safety and effectiveness. Learn more about saline breast implants, silicone breast implants, and cohesive silicone gel breast implants and the benefits and downsides of each type.

Breast Enlargement Surgical Techniques: Incision Location

The location of the incisions through which breast implants are placed is a very important consideration in breast enlargement surgery. While the surgeon's goal is to make the incisions as inconspicuous as possible, the size, shape, and type of breast implants used and each patient's unique body structure play a role in determining incision location. Learn more about the four incision techniques used for placement of breast implants: the inframammary fold incision, the areola incision, the transaxillary incision, and the navel incision.

Breast Enlargement Surgical Techniques: Implant Placement

Breast implants placed under the pectoral muscle can provide a more natural look but require more extensive surgery and a more painful recovery. Subglandular placement of breast implants for breast enlargement is easily accomplished and allows quicker recovery, but the results may not be as natural-looking. Learn more about submuscular placement and subglandular placement of breast implants and the pros and cons of each method.

Brest Lift/Mastopexy Surgery

2011-03-22T11:49:00.000-07:00

Mastopexy (breast lift) surgery denotes a group of elective surgical procedures designed either to lift or to change the shape of a woman’s breasts. Besides lifting the breast tissue and removing skin, a mastopexy might also include repositioning the areola and the nipple. In practice, a mastopexy can be effected as a discrete surgery, or as a subordinate surgery comprehended within a breast augmentation done for the emplacement of breast implants. The physical changes afforded by a mastopexy — the position and shape of the breast, by the (re) distribution of the existing breast tissues — are temporary, because the effects of gravity and of aging will continue acting upon the patient’s body, causing ptosis to recur in the course of time.

Mastopexy surgery procedures

Full breast lift

The full breast lift involves an incision along the crease underneath the breast, incisions around the areola, and a vertical incision between the areola and the base of the breast, called “anchor incision” and “inverted-T incision”. This technique removes excess skin, elevates the breast, and often reduces the size of the areola, and thus allows effecting maximal changes to the breast. As such, it is the most widely used, traditional surgical technique because it consistently produces the desired breast shape and breast position upon the chest wall.

The three, distinct scars, consequent to this mastopexy technique, are in three locations; each has a characteristic pattern of healing. In the peri-areolar area, the scarring is partially concealed by the lighter-to-darker change in skin color at the transition from the breast skin to the pigmented skin of the areola. The vertical, anchor incision from the areola to the breast crease can be hidden in shadow. The inframammary portion of the scar, that courses along the inframammary fold of the breast, often is the thickest of the three surgical scars, but it can be hidden in that fold. Moreover, although the coloration of these scars fades, they do remain visible, in most cases.

Modified breast lift

The modified breast lift effects the same transformation as a full breast lift, but with fewer consequent scars; yet, it is potentially limited, because the plastic surgeon can effect fewer changes to the shape of the breast. In surgical praxis, the modified mastopexy surgical technique often is performed as part of a breast augmentation. There are several, variant modified breast lift techniques: (i) the “Benelli breast lift” (“doughnut lift”), which is a concentric mastopexy that involves removing a ring of skin from around the areola in order to limit scarring of the areolar area; (ii) the “crescent lift” that also removes a ring of tissue from around the areola, but which takes more tissue from the area above the areola, thereby raising the nipple and areola on the chest wall; (iii) the “lollipop lift”, which involves an incision around the nipple and areola, with a vertical scar extending to the inframammary fold, the crease underneath the breast; and (iv) a “doughnut lift” variant that includes removing excess skin from underneath the breast.

How long will the results last?

Unless you gain or lose a significant amount of weight or become pregnant, your new breast shape should remain fairly constant. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman's breasts. If, after a period of years, you again become dissatisfied with the appearance of your breasts, you may choose to undergo a second breast lift procedure to restore their more youthful contour and appearance.

Results of a Breast Lift

Breast lift surgery will make your breasts firmer and more uplifted. The position of your areolas and nipples will be enhanced, and the size of your areolas will be aesthetically pleasing.

The incisions from your breast lift surgery will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible. In some instances, they will eventually be only faint lines. Certain individuals may have incision lines that are more noticeable. Fortunately, the incisions for your breast lift are in locations easily concealed by clothing, even low-cut necklines.

When can I resume my normal activities?

After breast lift surgery, it is often possible to return to work within a week or so, depending on your job. In many instances, you can resume most of your normal activities, including some form of mild exercise, after several weeks. You may continue to experience some mild, periodic discomfort during this time, but such feelings are normal. Severe pain should be reported to your doctor.

Any sexual activity should be avoided for a minimum of one or two weeks, and your plastic surgeon may advise you to wait longer. After that, care must be taken to be extremely gentle with your breasts for at least the next several weeks.

Am I a good candidate for a breast lift?

You may be a good candidate for breast lift surgery if you have one or more of the following conditions:

breasts that are pendulous, but of satisfactory size
breasts that lack substance or firmness
nipples and areolas that point downward, especially if they are positioned below the breast crease

Sometimes these conditions may be inherited traits. In certain cases, the breasts may have developed differently so that one breast is firm and well positioned while the other is not. There may be differences in the size of your breasts as well as their shape. Breasts that are large and heavy can be lifted, but the results may not be as long-lasting as when the procedure is done on smaller breasts.

A breast lift can be performed at any age, but plastic surgeons usually recommend waiting until breast development has stopped. Pregnancy and breast-feeding may have significant and unpredictable effects on the size and shape of your breasts. Nevertheless, many women decide to undergo breast lift surgery before having children and feel that they can address any subsequent changes later. Since the milk ducts and nipples are left intact, breast lift surgery usually will not affect your ability to breast-feed; however, you should discuss this with your plastic surgeons.

I understand that every surgical procedure has risks, but how will I learn more so that I can make an informed decision?

The subject of risks and potential complications of surgery is best discussed on a personal basis between you and your plastic surgeon, or with a staff member in your surgeon's office.

Some of the potential complications that may be discussed with you include bleeding, infection and reactions to anesthesia. Following a breast lift, sometimes the breasts may not be perfectly symmetrical or the nipple height may vary slightly. Minor adjustments often can be made at a later time. Permanent loss of sensation in the nipples or areas of breast skin may occur rarely. Revisionary surgery may sometimes be helpful in certain instances where incisions may have healed poorly.

You can help to lessen certain risks by following the advice and instructions of your plastic surgeon, both before and after surgery.

Breast lift surgery information

Commonly referred to as a breast lift or boob lift, mastopexy surgery raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour.

Enhancing your appearance with a breast lift

A woman's breasts often change over time, losing their youthful shape and firmness. These changes and loss of skin elasticity can result from:

Pregnancy
Breastfeeding
Weight fluctuations
Aging
Gravity
Heredity

Sometimes the areola becomes enlarged over time, and a breast lift will reduce this as well. A breast lift can rejuvenate your figure with a breast profile that is youthful and uplifted.

What breast lifts don't do

Breast lift surgery does not significantly change the size of your breasts or round out the upper part of your breast. If you want your breasts to look fuller, consider breast lift and augmentation surgery. If you want smaller breasts, consider combining breast lift and reduction surgery.

Is it right for me?

Breast lift surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image.

A breast lift is a good option for you if:

You are physically healthy and maintain a stable weight
You do not smoke
You have realistic expectations
You are bothered by the feeling that your breasts sag, have lost shape and volume
Your breasts have a flatter, elongated shape or are pendulous
When unsupported, your nipples fall below the breast crease
Your nipples and areolas point downward
You have stretched skin and enlarged areolas
One breast is lower than the other

Breast lift surgery at a glance

Breast lift surgery was one of the top surgical cosmetic procedures performed in 2009. 87,386 people had mastopexy surgery in 2009.

Age
13-19	2%
20-39	47%
40-55+	51%
Gender
Males	0%
Females	100%

Reduction Mammoplasty/Breast Reduction Surgery

2011-03-22T11:02:00.000-07:00

Breast reduction or reduction mammoplasty is a common surgical procedure which involves the reduction in the size of breasts by excising fat, skin, breast implants and glandular tissue; it may also involve a procedure to counteract drooping of the breasts. As with breast augmentation, this procedure is typically performed on women, but may also be performed on men afflicted by gynecomastia. In 2005, over 113,000 women had breast reductions, an increase of 11 percent from 2004.

Procedure

Doctors almost always perform breast reductions while the patient is under general anesthesia. During pre-operative visits, the doctor and patient may decide on new, usually higher, positions for the areolas and nipples.
For males, excess tissue may simply be removed through a tiny incision in each breast. This leaves minimal scarring^.
Patients may take a few weeks for initial recovery, however it may take from six months to a year for the body to completely adjust to the new breast size. Some women may experience discomfort during their initial menstruation following the surgery due to the breas
ts swelling

Results

Reduction mammoplasty affords the recipient smaller, lighter, and firmer breasts. The surgeon may also reduce the size of and change the shape of the areola or nipples. Both men and women typically have restored confidence, as well.It has been mentioned that patients who have received breast reductions are the happiest and most satisfied of all plastic surgery recipients

Risks

Possible issues include difficulty breast feeding, scarring, asymmetry, delayed wound healing, altered nipple sensation, fluid retention in the breast, altered erogenous function, and late changes in shape and recurrent ptosis (drooping).
It may impair the likelihood of breastfeeding success due to the surgical disruption to the lactiferous duct system. However, a number of studies have demonstrated a similar ability to breast feed when breast reduction patients are compared to control groups.
Scarring from this procedure may be extensive and permanent. Initially, the scars are lumpy and red, but they gradually subside into their final smaller sizes as thin lines, slightly discolored. Though permanent, the surgeon can make the scars inconspicuous to the point that even low-cut tops may be worn without visible scars
Breast reduction surgery

Breast reduction surgery reduces the breast size and weight by making it firmer with smaller areolas. During the surgery the key properties removed from the breast are glandular tissue, fat cells and redundant skin.

After the surgery the patient wears a special bra for few weeks to support the breast as they settle into their new shapes. The patient will lose sensation in nipples for some period. Numbness may also cover a part of your body for a short period. It is not recommended for women who desire to breast feed as it may worsen the likelihood of success and the volume of breast milk. Other problems due to the surgery may include, asymmetry, delayed wound healing, fluid retention and altered sensitive to sexual stimulation.

During the first menstruation after breast reduction the patient may experience swelling breast and pain, which will reduce with time. However of all the plastic surgery procedures, this result in the quickest body image change for you to enjoy the physical comfort of the perfect breast that will fit your clothes. The price for breast surgery may range between $3500 to $30,000 and more.

If you are scared to go through the surgery you can even take specific pills for breast reduction that work safely and instantaneously. For instance, Alexia breast reduction pill is a safe method to other alternatives, as it is100% safe with natural herbal supplements. It shows up to 50% significant reduction with no side effects. Another pill for breast reduction is Trima Breast Reduction pill. However consult the right physician for the right pills according to your body function.

Whatever may be the risk in the surgery there are many women who wish to go for it due to the psychological and physical problem that they face. However be prepared emotionally if you wish to undergo a surgery. Be clear in your decision and face the situation or go for the natural pills available in the market. Walk out of the dark closet of shame and grief. Walk with pride and dignity for you're the admirable part in your body.

Breast Reduction Costs and Consultations

The cost is mostly determined by two things, the size of the reduction and whether or not you are going to be using insurance to cover some or perhaps all of the costs. There are many smaller things that can go along with a breast reduction like nipple reduction and whether or not the nipples will be attached to a blood supply. You're doctor should give you an estimate sheet with all the costs of each little procedure for you to select. Prices can range from as little as $3500 up to $30,000 and more.

Take a look at the list of questions link on the side of this page. You'll want to ask as many of those questions as are appropriate for your surgery. The first thing to look at is the before and after portfolio that the doctor will have. Remember that these will be the best case scenarios. You're doctor will most likely take pictures for insurance pre-approval and will be marking areas of your breasts with a pen. Don't even think about doing this consultation when you're near or on your period. Remember to only go with a doctor that you felt comfortable with during this consultation, this is the person that will be altering the rest of your life. If the doctor is not listening to your concerns and keeps trying to get you to realize his/her way is best, then you need to find a new doctor, be careful.

Breast Augmentation Surgery

2011-03-22T04:39:00.000-07:00

Breast Augmentation - Increasing The Breast Size

Introduction: BREAST AUGMENTATION is a cosmetic surgery to increase the size of small breasts. In young women breasts may remain small due to underdevelopment of glands for genetic reasons. In grown up women, breasts lose their volume due to multiple pregnancies and repeated lactation. With advancing age also the breasts become small and start sagging. BREAST AUGMENTATION is a major surgery designed to increase the breast size to desired size. This surgery is done under General anaesthesia.

Breast augmentation is done by putting silicone implants under the breast. There are different types of breast implants in use nowadays.

1. Silicone gel filled
2. Saline filled
3. Shape implants like ‘pear shaped’

The surface of silicone implants can be smooth or textured (rough)

TYPE S OF IMPLANTS:
Picture 1: Saline filled
Picture 2: Silicone gel filled
Picture 3: Shape implants

Position of Implants

Silicone implants are placed either under the breast or under the pectoral muscle (preferred position). Both placements have their particular indications which are discussed during a consultation at the clinic.

POSITION OF IMPLANTS:
Picture 1: Under the breast
Picture 2: Under the chest muscles

SOME RESULTS: Before & After

25 yrs old unmarried woman: achieved very satisfactory breast shape after augmentation with 200 cc saline filled textured implants

32 yrs old woman, mother of two children: Breast augmentation done with 220 cc saline filled textured implants. Patient was very happy and satisfied with the results

Breast Augmentation

Augmentation mammoplasty is the medical term for breast augmentation. Also referred to as breast enhancement or breast enlargement, this type of plastic surgery involves placing silicone or saline breast implants either behind the breast tissue or beneath the chest muscle to add size, shape, and fullness to the breast. Breast augmentation can be performed to make smaller breasts appear larger, balance breasts that are asymmetrical, or restore fullness that has diminished with age or as a result of pregnancy.

Breast Augmentation Surgery

The breast enhancement process can take several weeks from the initial consultation through post-surgical recovery, and involves close communication and cooperation between patient and surgeon. Before breast implants are placed, many decisions must be made, including the type and size of the breast implant, where it will be placed, and the location of the incision. The patient will also be asked to follow some specific instructions from the doctor during the weeks preceding the operation.
During breast enlargement surgery, the surgeon will place the breast implants according to the decisions made during the planning stages. This process usually takes between one and two hours.
After breast augmentation surgery, the patient will most likely be drowsy and sore for a day or two. Although the patient should be able to get up and move around after about 48 hours, there may be some lingering side effects for a couple weeks to a month. The patient should follow the surgeon’s instructions closely during this healing period and have a friend or relative agree to drive them home and provide assistance for a couple of days.

Breast Augmentation Recovery and Results

The length of the breast augmentation recovery process depends heavily upon the patient’s condition, the degree of enlargement, and several other factors, but usually lasts between a few weeks and a couple of months. Breast implant results will also vary from person to person and are most satisfactory in patients who have reasonable expectations.

Breast Augmentation Risks, Complications, and Benefits

Although there are many benefits that result from breast augmentation surgery, including improved self esteem, a more balanced figure, and more choices in clothing, there are also a number of risks involved with breast enhancement that should be carefully considered before choosing to undergo surgery. Capsular contracture, ruptured breast implants, and other complications can interfere with the appearance of results and may require additional surgery to repair damage or remove the implants.

Am I a Candidate?

Only a qualified cosmetic surgeon can determine whether breast enlargement is right for any one individual, but there are some groups for whom it is generally considered unadvisable and others for whom careful consideration is recommended, such as teenagers. Young women under the age of 18 are generally considered not to be good candidates for breast implants because the breasts continue to develop on into the early twenties. To find out if you are a candidate for breast augmentation, or another plastic surgery procedure such as liposuction, schedule a consultation with a qualified surgeon in your area by using DocShop's comprehensive directory.

Breast Augmentation Cost and Financing

Augmentation mammoplasty is an elective cosmetic surgery and as such, these procedures are not covered by insurance plans. For most, the cost of breast enhancement surgery is an important consideration. Since breast implant prices and surgeons' fees alone are expensive and do not make up the entirety of the cost, some may be tempted to go to a surgeon who offers discounts or low prices. This is usually a mistake. A surgeon who offers discounts is usually one who either lacks experience or has a less than satisfactory record of results. Breast augmentation financing is available to help women pay for the cost of surgery so they don't have to settle for an inexperienced surgeon and risk their health or the quality of their results.

Choosing a Breast Enlargement Surgeon

Selecting a breast surgeon is undoubtedly the most important decision a patient can make about her breast augmentation. In addition to being board certified and experienced in breast enhancement surgery, the surgeon should be someone the patient feels comfortable with.

Cervicoplasty Surgery

2011-03-22T03:20:00.000-07:00

What is Cervicoplasty?

Cervicoplasty, also known as neck recontouring, or necklift, is a procedure that “lifts” the neck by tightening loose, sagging, and excess skin. This is done because loose and sagging skin can give an impression of poor health, age, even stress. By removing and tightening loose skin, the neck appears to be revitalized and more youthful, improving the overall appearance of the person.

Neck Recontouring Procedure

The procedure begins with an initial consultation with the surgeon. The patient and doctor exchange information, including what the patient wants from the procedure, what the surgeon can project as a result, any health related problems and issues that might hinder the procedure, and an explanation of how the procedure will go.

Once the patient is well informed and agreeable to the procedure, the surgeon begins taking measurements and notes of the areas that need to be treated. Once everything is in place, the patient is given anesthesia. Choices depend on the preference of the patient, but usually, a light anesthesia that makes the patient fall asleep is what is administered.

Tiny incisions are made, below the chin, and under each ear. These incisions are usually made in the natural crease of these two areas in order to reduce the visibility of any scarring. Once the incisions are made, the surgeon inserts an endoscope and is guided to the target areas, where the surgeon begins restructuring platysma muscle, reinforcing it and contouring it to give definition to the neck.

Next, the surgeon, using the endoscope, creates a tunnel from the back of one ear all the way to the back of the other, and places a device that acts like a corset, which helps in tightening the skin of the neck, smoothing the area where the chin meets the upper neck. The incisions are then closed, and the procedure is complete.

The whole process can take between 1-2 hours, depending on the amount of work that needs to be done.

Possible risks, complications, and recovery time

Possible risks include infection, which can happen at the areas where the incisions are made. It is important that patients take the prescribed medication regularly, and follow the surgeon’s instructions. Bruising and swelling can occur, which can be treated with ice packs. Recovery time can take anywhere between 3-4 weeks.

Overview

The first thing that is noticed in a person is definitely his or her face. Naturally, the eyes immediately move to the face to identify the person and to assess their appearance. And while this is the case, the neck plays a critical part in the person’s appearance as well. This is because the neck, just like the face, is a good indicator of the person’s age, health, and well-being.

Many times, people fix up their face with make-up, or some plastic surgery, to try and reduce the effects of aging. But when their necks show sagging and loose skin, it immediately gives away the true range of the person’s age. This is why it is also important to ensure that the neck looks just as rejuvenated and young as the face, and this can be done through a process called cervicoplasty.

cost

Before asking for a price, please make sure that you've found the right consultant to give you a diagnosis for what you dislike and then formulate an appropriate operation. If you have a localized fat deposit under your chin, liposuction of this submental area, may suffice. On the other hand, if you have excessive and poor quality skin with loose muscle bands, a formal "necklift" or cervicoplasty will be preferable. In my practice, we offer patients the choice of MAC (monitored anesthesia care) or general anesthesia, for both procedures. The salient differences between the two procedures are as follows:
a. Recovery time: Cervicoplasty 1 week; Submental lipo 3days
b. Length of scars: Cervicoplasty around and behind ears; Lipo 1-2 "stab" 1cm incisions.
c. Risks: comparable
d. Price: Cervicoplasty $5,000; Lipo $3000.
e. Operating time: Cervicoplasty 4hr; Lipo 1hr

Types of Neck Lift Surgery: Cervicoplasty & Platysmaplasty

Neck lift surgery, to achieve great results, tends to combine two main procedures, the cervicoplasty and the platysmaplasty. Both are usually incorporated in the surgery, though the use of the platysmaplasty procedure depends on the state of your neck muscles. If they are in good condition, i.e. they are taut and strong, then a platysmaplasty is unnecessary, but if they droop, creating what is called banding, a platysmaplasty can tighten the muscle.

Cervicoplasty

The cervicoplasty corrects limp and drooping skin caused by ageing, rapid weight loss or medical problems. This procedure is the least complicated of the two since it involves the reduction of drooping skin and a repositioning of the tissue.
To begin with, the surgeon makes an incision behind each ear to create a position from which to tighten the skin. The freed skin is then trimmed. How much is removed depends on what look you discussed with your surgeon. The reduced skin is then repositioned over the neck. The neckline is therefore tightened, because the trimmed skin is stretched over the same area as before. This means that the skin is pulled upwards and backwards, enabling the jaw line and neckline to be better defined. The redraped skin is then sutured by stitching, tissue glue or staples. A bandage will then be wrapped around the head to protect the suture. A compression bandage could be used; talk to your surgeon about what is best for you.

Platysmaplasty

For the platysmaplasty, an incision is usually made under the chin to gain better access to the neck muscles. The surgeon, depending on which procedure he or she is following, either realigns muscle, partially removes it, sutures muscle together, or perhaps does all three. This results in the tightening of the central area of the neck. Which procedure your surgeon follows, though, depends on your needs and desires and your surgeon’s abilities.

Corset Platysmaplasty

If you especially suffer from banding (in which your skin hangs off slack muscle), then it is likely that your surgeon will follow the corset platysmaplasty procedure. He or she may first remove some muscle or perhaps realign the muscle, but the corset platysmaplasty focuses particularly on creating a muscle sheet. This means skin cannot amass round drooping muscle. It also means that the chance of banding returning is reduced, therefore making the corset platysmaplasty especially suited for those predisposed to banding. To reduce the return of slack muscles the muscle is made stronger by suturing the muscle together in a continuous line down the front of the neck. When this is done, the incision is closed and the face bandaged.

Hammock Platysmaplasty & Purse-String Platysmaplasty

As said before, the corset platysmaplasty is best suited to people that suffer from banding. Other procedures exist that can be better suited to correcting a particular neck problem other than banding. Certainly the purse-string platysmaplasty is more suitable for a male patient. This is because the deeper structure of men’s faces and necks makes the process more appropriate.
The hammock platysmaplasty is another example of a different platysmaplasty procedure. It could, though, be used in conjunction with the corset platysmaplasty because it can further protect against neck banding. The procedure uses mesh or Alloderm as a “hammock” to capture loose muscle and keep the neck tight. A hammock platysmaplasty is certainly the best option for you if you suffer from banding and your muscles are very weak. A corset platysmaplasty would only be successful if the strengthened muscle has some remains of strength in it. If muscle is exhausted, then a “hammock” of mesh or Alloderm does the work for the muscle, therefore making it more appropriate for people with worn out muscles.

Neck Reduction Surgery

2011-03-22T02:35:00.000-07:00

Reduction of Neck

Aging of the face and neck results in ptosis of soft tissues and the appearance of more prominent facial lines.1 For correction of these changes, surgeons are increasingly reporting procedures with fewer incisions and shorter postoperative recovery periods. Many of these procedures utilize nonabsorbable sutures in the dermis and subcutis to lift lax skin.^2-10 Limitations of these implants have included the protrusion of sutures through the skin,^2-3 asymmetry of cosmetic effect requiring correction with additional sutures,^3-5 and limited durability of effects.⁴ A new modified polypropylene suture marketed as Contour Threads™ was approved in 2005 by the US FDA for lifting ptotic skin of the face and neck. This implant is supplied as a 25cm polypropylene suture with a barbed middle portion. It is attached to a 7-inch straight needle distally and a 26mm 1/2 circle taper needle proximally.

There are several potential advantages of this new implant. It is designed to tie with a paired suture and be anchored to underlying fascia or periosteum, theoretically reducing the likelihood of migration and loss of cosmetic effect. Similar to the Isse Endo Progressive Face Lift Suture,⁶ and in contrast to the Aptos thread, the barbs along this suture are oriented in only one direction. These unidirectional barbs when combined with more secure anchoring ideally limit and lock motion into one well-controlled vector. This also allows for postoperative correction of asymmetry of tightening. Finally, the suture material is clear, making it difficult to visualize under thin or transparent skin.

Procedure and Technique

Placement of Contour Threads™ to reduce ptosis of the brow, neck, middle and lower face may be performed in an outpatient setting under local anesthesia. The surgeon first establishes the degree and direction of the desired tightening. This determines the course and number of sutures that will be placed. Infiltration of local anesthesia is limited to these lines and the insertion points of the straight needle.

For lifting of the brow, middle, and lower face, 3-4mm incisions for insertion of the straight needle are made posterior to the frontal and temporal hairline. For lifting of the neck, incisions are made posterior to the sternocleidomastoid muscle of the lateral neck. To place an individual thread, the surgeon guides the straight needle through the incision and into the subcutaneous plane. For some anatomic locations, it is advantageous to bend the needle to more easily allow it to follow the curves of the face. The needle is advanced in this plane in a zig-zag movement along the marked trajectory. Once anchored, this zig-zag placement of the suture limits retrograde motion along the suture and results in an implanted suture that is longer than the drawn trajectory. This maximizes the number of barbs in the subcutis and theoretically provides more stability of the translocated skin.

Movement of the needle and suture through the subcutis is generally well tolerated by patients. If the straight needle moves superficially to this plane it is immediately apparent as linear dimpling of the overlying skin. If the needle enters the deep subcutis or approaches the muscle fascia or periosteum, the patient will report the sensation of pain or pressure. At any point, the straight needle may be partially or completely removed and repositioned.

The straight needle exits the skin inferior to the eyebrow or near the medial face or neck. It is cut from the thread after pulling the attached suture through the skin. This leaves the barbed portion of the thread buried in the subcutis with the free ends extending from the proximal insertion point and the distal medial face exit point. The curved needle on the proximal end of the suture may then be used to anchor the suture near its insertion to the underlying fascia or periosteum. A 3-4mm incision, 1-2cm posterior to the insertion points serves as an exit point for the curved needle after deep suturing to the fascia or periosteum. Greater security of this anchor point is achieved by tying this suture at its proximal end with a paired suture running a similar parallel course in the skin. The resulting knot can be seated in this posterior incision by gentle traction on the distal ends of the paired sutures.

When all planned sutures have been placed and anchored, the patient returns to the seated position. Holding the distal end of the suture protruding from the medial face, brow, or neck with one hand, the surgeon uses the other hand to push the lax skin overlying the suture towards the anchoring point. The unidirectional barbs catch on the fibrous septae of the subcutis preventing retrograde movement. Together, the surgeon and patient decide the degree of tightening along any given suture. The distal end of the suture extending from the medial face, brow, or neck is cut at its exit point and retracts under the skin. Incisions used for insertion of the straight needle and anchoring heal rapidly by secondary intention.

Translocation of the skin along the suture causes the lax skin of the face and neck to accumulate at the hairline and lateral neck. The resulting folds of skin are quickly and almost completely remodeled or redistributed to the scalp and neck in several days to weeks, even in older patients with relatively inelastic skin. Mild complications such as swelling, bruising and subjective feelings of "tightness" usually resolve within 1-3 weeks. Transient neuropathy of the greater auricular nerve has occurred in several patients when using the sternocleidomastoid muscle fascia as an anchoring point on the lateral neck. Leaving the knotted proximal ends of the paired sutures unanchored in the subcutis is a cosmetically acceptable alternative in this location. It is not clear if this will reduce the incidence of mononeuropathy or be as stable as an anchoring point, although preliminary results suggest that the incidence of neuropathy drops significantly with this technique modification.

After the resolution of initial postoperative swelling, any subjective discomfort from tightening or perceived asymmetry of tightening may be addressed without inserting more sutures or creating new incisions. Carefully applied firm retrograde pressure along a suture will result in the focal release of several underlying barbs from their attachment to fibrous septae. This release can be appreciated as a subtle clicking sensation under the surgeon's finger. Threads have been successfully released up to 9 weeks postoperatively.

Discussion

Because the Contour Thread™ barbs may be released with intense pressure, patients must initially avoid strenuous exercise or movements that could dislodge the tightened skin from the hundreds of barbs along the sutures. Non-peer reviewed data from the manufacturer demonstrate that in laboratory rats these sutures develop a fibrous capsule that becomes well integrated into the dermis and subcutaneous tissue over several months.11 Theoretically, a similar process in human skin could lead to a secure and long-lasting cosmetic effect. The actual long-term durability of the tightening effects of these sutures is unknown. Early adopters of this procedure have demonstrated maintenance of cosmetic effects at 6 months.¹²

Outcomes with more than 25 patients at our center for up to 12 weeks have been excellent. All but one of these patients have maintained greater than 90% of their initial correction, and all have been satisfied with their results. One of our earliest patients reported a subjective appreciation of a 50% loss of tightening at 11 weeks. This loss of tightening effect may be a result of the fact that early in our experience we used fewer threads on the middle and lower face than we do now.

Conclusion

The use of barbed sutures appears to be a viable strategy for lifting and repositioning of facial tissue. The recently US FDA approved Contour Threads™ provides advantages to the surgeon and patient that other thread systems do not. However, the early success seen with Contour Thread™ lifts must stand the test of time.
Longer follow-up studies are essential, and final judgments as to the utility of these threads cannot be made in the absence of longer term (i.e., greater than 6 months) data.

The optimal techniques for placement and removal of sutures, the consequences of long-term subdermal polypropylene placement, and the potential for revision and retightening of extant sutures should be the subjects of future investigation.

Neck Lift Surgery

2011-03-20T06:24:00.000-07:00

What is a Neck Lift?

Neck-lift plastic surgery can be performed in a variety of ways, depending on the needs of the individual. Three possible neck-lift procedures include:

liposuction
cervicoplasty
platysmaplasty

Typically, a neck-lift will include liposuction to remove fat. Cervicoplasty may be included to remove excess skin, and platysmaplasty to remove or tighten neck muscles: a process that gets rid of unwanted band lines. These procedures are described later in this article.
A neck-lift may also be part of a combination treatment plan, in conjunction with a forehead lift, facelift, or eyelid surgery. For a less invasive alternative, you may want to investigate the micro neck-lift.

The Right Candidate for Neck-lift

There is no ideal age for neck-lift surgery. Candidates may range from teenagers to octogenarians. People who suffer from certain diseases may be excluded from treatment. Talk to a qualified plastic surgeon about your goals and expectations, and to determine if you would be a good candidate. Your doctor will also review your medical history and the risks associated with the procedures to create a treatment plan that works best for you.

The Neck-lift Procedure

Neck-lifts are most often performed by a board-certified plastic surgeon. The location of the procedure may be the doctor's office, outpatient surgery center, or hospital. Since there may be more than one procedure performed during a neck-lift, your time in surgery may be one hour to several hours. The procedure may be performed under local anesthesia or general anesthesia, but usually does not involve an overnight stay.
The procedures involved in a neck-lift may be performed endoscopically. For an endoscopic neck-lift, an instrument visually guides the surgeon through the procedure. The advantages of an endoscopic procedure may include a smaller incision, no general anesthesia, reduced bruising, and faster recovery. You can talk about the endoscopic option with your doctor.

Who would best Represent an Ideal Candidate for Neck Lift?

A neck lift can improve upon the appearance of the neck by creating more definition of the angle of the jaw. Undergoing this procedure can provide a boost to one’s self-confidence and self-esteem. A neck lift can be performed on individuals above 18 years of age who feel the need to improve their necks. Typical patients range between the ages of 30 and 70. A neck lift can address various cosmetic issues, including:

Turkey neck
Excess fat and/or skin in the neck
Retrognathia

If you are self-conscious about these issues, you can be considered a good candidate for a neck lift. However, patients who undergo this procedure should also have realistic goals and expectations as well as be physically and mentally stable. People must remember that cosmetic surgery is meant for improvement, not perfection.

Are there other options to improve the appearance of the neck?

A necklift is a combination of various procedures, but for some, one procedure alone could improve the appearance of the neck.

Neck Liposuction: Removing fat alone can improve problems in the neck. However this is only available to patients who have little excess skin in the neck region. If they do not have excess, droopy skin, neck liposuction will present a beautiful result.

Facelift: A facelift removes excess fat and skin from the facial area, including the neck. This procedure can tighten a jawline that grows slack and jowly and those with folds and fat deposits around the neck. This is more beneficial to those wanting to improve upon signs of aging in their face as well as the neck. A facelift also helps those who have no excess fat in this region, but possess a significant amount of excess skin.

Chin implant: This is for people who have a weak chin and, as result, the neck looks overly fleshy. Chin implants can also help those with retrognathia, a condition where the jaw is receding.

Please discuss with your surgeon as to which procedure will work best to meet your needs

How Much Pain is Associated with Neck lift?

There will be some discomfort after undergoing neck lift surgery, which can be lessened with prescribed pain medication. Some degree of swelling and possibly bruising can be expected, but this is only temporary. It is recommended that you stay home for at least a week after surgery and take it easy for the first three weeks following surgery.

What happens after undergoing a Neck Lift operation?

During the recovery period, doctors usually have patients wear a compression garment for several days. This garment helps improve blood circulation, minimize swelling, and flush out potentially harmful fluids. The compression garment can allow the patient to heal from their necklift faster and minimize the amount of downtime while providing comfort and support to the neck.

Even though swelling takes a few weeks to subside, patients should be able to start seeing the results of their neck lift within a week following surgery. Patients will notice more definition in their neck and under the jaw line.

The duration of the results depend on the type of procedures used. The neck lift procedure can last about five to ten years, but this varies from patient to patient. A facelift also lasts about the same amount of time. Patients can choose to undergo another facelift and necklift when they start to notice their results fading. Otherwise, their appearance will revert to a pre-surgical state. Liposuction permanently removes fat deposits from the neck. Fat can still grow in other areas, and that is why it is important to stay in shape even after undergoing liposuction.

What Are the Risks and Limitations of Neck lift?

With any cosmetic procedure, there is always the possibility of risks. A neck lift may involve multiple procedures, so, there is an increased risk. The most common risk for any cosmetic procedure is allergic reaction to the anesthesia and infection. Another potential complication is accumulation of blood under the skin (hematoma). Yet another risk is injury to the nerves that control muscles in the treated area. Excessive scar tissue is another possible cause for concern, however, scar revision procedures can help.

These risks can be reduced when the procedure is performed by a qualified surgeon, with extensive experience in performing neck lifts and if patients follow their doctor’s pre-op and post-op instructions. Note: Smokers should stop smoking two weeks before surgery because this contributes to poor healing of the skin.

What Are The Typical Costs Associated With Neck Lift?

Since a neck lift may involve several procedures performed at once, the cost of undergoing this procedure can range anywhere from $3,000 to $15,000. Liposuction alone averages $1500, a facelift usually costs $4000, and a chin implant runs about $1,700. Fees within various regions may also vary depending on whether the doctor’s practice is in an urban, suburban or rural area. When considering costs for a neck lift, make sure the total figure includes any and all associated costs. A comprehensive cost figure may be obtained while consulting with a cosmetic surgeon.

Unfortunately, most medical insurance providers do not cover cosmetic surgery procedures. However, most surgeons do offer multiple financing options. CosmeticSurgery.com provides information on various ways patients can fit a neck lift into their budget

Are You a Candidate for a Neck Lift?

If you have jowls, a double chin, a turkey wattle or any other cosmetic concerns about the appearance of your neck, seek a consultation with a board-certified facial plastic surgeon.
During this consultation, your surgeon will take a thorough medical history to see if you are healthy enough to undergo neck surgery. Don't hold back. Mention any past surgeries and/or drug allergies or problems with anesthesia. Tell your surgeon about any and all medications you take on a regular basis. This includes supplements. Many medications and herbal or dietary supplements interact negatively with anesthesia and other drugs.
You must have realistic expectations about your neck lift, and what it can do for your appearance and your life. You also must be able to clearly communicate your aesthetic goals to your surgeon. After a frank discussion, your surgeon can determine whether your goals are realistic and can be met with a neck lift.
There will also be a physical component to this visit. Your surgeon will assess the amount of excess fat or loose skin in your neck area as well as the quality of your skin and muscle tone in this area.
Your surgeon will make suggestions regarding your neck lift, including the recommended technique, anesthesia and incision placement options. He or she should also discuss neck lift risks, neck lift recovery and neck lift cost.
Some surgeons charge for consultations, others don't. The consultation fee may be deducted from the neck lift cost if you decide to book a surgery. You should not feel pressured to book a neck lift on the day of your consultation.
The next step in the process is your preoperative appointment. This visit allows you to ask more questions and revisit any concerns you have about your neck surgery. You should also be given clear instructions about what you can and can't do in the days and weeks leading up to your neck lift, such as avoiding alcohol and not taking over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen. (NSAIDs increase your risk of bleeding.) If you smoke, quitting before your neck lift is important. Smoking impairs circulation and wound healing. Ask your surgeon which smoking cessation tools are most appropriate. You may also be given prescriptions for antibiotics and pain relievers to fill before your surgery.
Routine blood work and a physical exam may be required before your neck surgery. These measures are in your best interest and will help make sure you are healthy enough to undergo neck surgery. If you are a woman, you may be asked to take a pregnancy test.

Recovery & Downtime :

Most patients can return to non-strenuous work after 5-10 days. However, for the first several weeks after surgery, you should avoid bending over, lifting heavy objects, and even turning your head from side to side. You will also have to sleep with your head elevated for one or two weeks. These guidelines can vary widely based on the patient’s personal health, the techniques used, and other variables. Always follow your surgeon’s recommendations.

How a Neck Lift Is Done

Typically, the procedure will last two to three hours. Of course, if you are having a neck lift in conjunction with liposuction, facelift, brow lift, or other surgeries, the time will vary accordingly. Your exact procedure will depend on your desired results and your own personal circumstances. In order to undergo a neck lift, you must be in good general health, both physically and mentally.
What do you dislike about your neck? Be honest with yourself! You're putting a lot of time and effort into researching the surgery, so make sure you get the results you want. You also should write down your thoughts on what you'd like to correct and have that with you at the time of your pre-operative consultation.
Here are some of the most common concerns:

Turkey wattle neck
Excess fat
Too much skin

Otoplasty Or Ear Surgery,Ear Pinning

2011-03-20T05:47:00.000-07:00

Otoplasty, is a cosmetic surgery to change the appearance of a person's external ears. Otoplasty can take many forms, such as bringing the ears closer to the head (often called ear pinning), reducing the size of very big ears, or reshaping various bends in the cartilage. Other reconstructive procedures deal with the deformed, or absent (microtic) ears. Otoplasty surgery can involve a combination of moving, reshaping, adding, or removing structural ear elements. This procedure is usually performed by either an oral and maxillofacial surgeon, plastic surgeon, or ENT surgeon.
The pinna, or external ear, is made of a thin structural cartilage covered over with thin skin. Each of the various folds and structures of the pinna is named. Ear deformity results from distorted, damaged, or missing ear elements. Many otoplasties are performed not because of actual deformity, but because the individual is displeased with the shape of their ears.

Candidates for Otoplasty

Most cosmetic ear surgery patients are children between the ages of four and fourteen. The ears are fully grown by age four, and the sooner a child undergoes otoplasty, the less teasing and embarrassment he or she will experience growing up. Learn more about pediatric otoplasty.
Ear plastic surgery is also an excellent option for adults who suffer from large, protruding ears or stretched earlobes. Adults of all ages are generally excellent candidates for otoplasty surgery.

Ear Surgery (Otoplasty) Cost and Financing

The cost of ear surgery varies depending on the difficulty of patient's condition, extent of the surgery, experience of the surgeon, and other factors. Otoplasty typically costs around $2,000 to $5,000. Financing options for ear surgery are available.

Preparing for Otoplasty

The otoplasty process begins with a consultation with a cosmetic surgeon. The surgeon will go over your ear surgery options and discuss your goals. Detailed pre-operative information and requirements will also be discussed. Otoplasty generally requires some form of sedation, and this will also be explained to you during a pre-operative appointment. Learn more about preparing for otoplasty.

About the Ear Plastic Surgery Procedure

There are different types of surgery for ear correction, and depending on which one is being performed, otoplasty typically takes about one to two hours to complete. The patient is placed under sedation while the cartilage of the ear is reshaped and any excess skin removed. Read more about the otoplasty procedure.

econstructive Ear Surgery (Otoplasty)

Ears affected by a birth deformity or a traumatic injury can be corrected with reconstructive ear surgery. Problems such as microtia (underdeveloped outer ear) and ear injuries can be treated with a variety of ear reconstruction procedures.

Recovery from Ear Surgery

Postoperative ear surgery patients experience very few side effects. Recovery from ear surgery can take up to six weeks; however, adult patients can typically resume their normal routines a few days after their procedure. Children generally require a week of rest before going back to school.

Otoplasty Results

Otoplasty involves one of the shortest recovery times of any plastic surgery procedure. Once the bandages are removed after the surgery, ear surgery results will be immediately visible. It is imperative that patients closely follow their surgeon's instructions and not tamper with or remove postoperative bandages before the surgeon allows.

Otoplasty Risks, Benefits, and Side Effects

Cosmetic ear surgery can correct a variety of problems, including cupped, folded, or protruding ears. The procedure can also help eliminate self-esteem problems caused by having visible ear deformities. Learn more about the benefits of otoplasty.
Although ear plastic surgery is known to be one of the safest plastic surgery procedures, there is always some risk involved in the procedure. Infection, overcorrection, and an extremely rare risk of altered hearing are all potential complications associated with ear surgery.
Side effects of otoplasty include postoperative pain, itching, and some degree of numbness. However, these are typically minimal and can usually be alleviated with medication.

Ear Surgery for Men

Ear plastic surgery has become one of the most popular cosmetic surgery procedures among men, being able to dramatically improve the appearance of the ears and provide a boost in self-confidence. Read more about male ear surgery.

Are you suitable?

Surprisingly, ear surgery is best performed on children as the cartilage in their ears is more soft and pliable meaning that it is easier to be reshaped. The best results can be achieved on a child between the ages of 4 and 14. This doesn't mean that adults are ruled out though; cosmetic ear sugery is also an excelent option for adults who suffer from large or protuding ears or stretched earlobes.
People who are suitable for cosmetic ear surgery usually have one or more of the following concerns...

Large or protruding ears
Enlarged earlobes
’Cauliflower ears’
’Lop ears’ (where the ear tips fold down and jut forward)
Deformed or misshapen ears
Very small ears

A consultation with a surgeon will confirm whether cosmetic surgery is right for you. If you suffer from severe ear deformities or if your ears have been damaged during sport or during an accident then you might require more complicated reconstructive ear surgery. This is a slightly more complicated procedure which will most probable need a longer preparation and recovery time.

Before Surgery

The surgeon will examine your ears in a consultation and discuss with you the type of surgery which is best suited to your situation. In your consultation you should make clear to your surgeon your goals and expectations of the procedure.
A good surgeon will take you through the associated risks and complications of the surgery. It is important that before surgery, you are fully aware of the procedure, what is involved and the positive and negative implications of the surgery. Try and do some of your own research before your consultation so you can ask your surgeon well informed questions. This will enable you to make a more informed decision whether or not to go ahead.
It is a good idea to ask your surgeon to show you before and after pictures of previous clients so you can get an idea of the work they have done before and what can realistically be achieved.
Once you have decided to go ahead with the surgery, your surgeon will give you a consent form to sign; make sure you read this and all the associated material very carefully before you sign anything. The surgeon will also take photographs of your ears before surgery in order to make comparisons afterwards.
It is a good idea to make your Doctor aware of the surgery in case there are any complications afterwards and you need to go and see them.

Infection is one of the most common complications of any surgery. Infections can be easily combatted with antibiotics, however in rare cases infection can require surgical damage and could leave scar tissue.
Blood clots rarely occur, however when they do, they can easily be removed with a needle, or tthey may even dissolve naturally. If you experience any prolonged swelling and/or bleeding you should contact your surgeon to ensure that your ears are healing properly and there are no blood clots. Hearing loss is extremely rare and a highly skilled ear surgeon is able to evaluate the possibility of such a risk and take the necessary steps to avoid any hearing damage.

Hair Transplantation Surgery

2011-03-20T04:14:00.000-07:00

What is hair transplantation?
People suffer from pattern baldness for various reasons, heredity leading the list. Stress, disease and harmful medication too can result in male pattern baldness and hair transplantation is the most effective solution for it. The process involves transplantation of the scalp’s hair-bearing portion onto the bald area. Thanks to recent technological advances hair transplantation is today considered one of the most convenient and affordable methods of medical hair restoration. No wonder it is so popular among the balding masses, though there are several alternatives to the hair transplantation method of medical hair restoration. Intake of Propecia is a prominent one.

Hair Transplant Procedure

Why hair transplantation is favored
Hair transplantation is the most effective method of dealing with male pattern baldness. The surgery involves removal of the scalp’s hair-bearing portion and transplanting it onto the bald patch. Recent technological advances have made hair transplantation so convenient and affordable that it is today the most popular method of medical hair restoration.

Besides the hair transplantation method of medical hair restoration there are other options for surgical hair restoration, Propecia being a prominent one.

Procedure of hair transplantation

Hair transplantation surgery is a delicate affair calling for a series of precautions. In the surgery that takes about four hours the scalp is treated with certain antibacterial chemicals and then shampooed.

The surgery involves harvesting a strip of hair from the scalp’s hairy area, or the donor strip, that measures 1-1.5 x 15-30 cm. Great care is taken while removing the excess fatty tissue to ensure that the vital follicular cells come to no harm. Using binocular microscopes for close inspection the surgeon punctures the graft-receiving sites with a fine needle. These are then arranged according to a predetermined density and pattern and the individual grafts placed on the problem patches. Normally 50 grafts per square centimeter are considered enough for providing acceptable hair density.

When done properly this method of medical hair restoration can yield breathtaking results. It becomes hard to tell whether the hair is natural or been transplanted. Surgery is also convenient because much less time is used up in separating the follicular units and their transplantation in the problem areas.

In hair transplantation surgery it is also possible to save the follicular units from iatrogenic injuries that bedevil the dissection phase and during placement of grafts.

Precautions before and after surgery

Several precautions are taken while conducting hair transplantation surgery, of which the patient is informed in advance. S/he also decides whether to go in for single or multiple sessions. But it is important that no medicine other than the antibiotics prescribed by the surgeon is taken and the patient stays off alcohol for a designated period before surgery.

The operated area must not be shampooed or exposed to sunlight for some days after surgery. And don’t get scared if some of the hair falls off in the displaced area. This is part of the process of hair renewal and re-growth takes just a few months to resume.

After the hair transplantation surgery the patient loses hair in only the areas where none was transplanted. Whether to go in for medication or hair transplantation treatment of the untreated areas is the patient’s prerogative. But if he s/he has opted for surgery in one portion it makes sense to repeat it in the newly balding areas as well. For remember that medication isn’t half as effective as transplantation in these extreme cases.
What is hair transplantation?
People suffer from pattern baldness for various reasons, heredity leading the list. Stress, disease and harmful medication too can result in male pattern baldness and hair transplantation is the most effective solution for it. The process involves transplantation of the scalp’s hair-bearing portion onto the bald area. Thanks to recent technological advances hair transplantation is today considered one of the most convenient and affordable methods of medical hair restoration. No wonder it is so popular among the balding masses, though there are several alternatives to the hair transplantation method of medical hair restoration. Intake of Propecia is a prominent one.
Causes of pattern baldness Most people who lose scalp hair are genetically predisposed to pattern baldness. Such people have a male hormone in their hair follicles, called testosterone, that gets converted into dihydrotestosterone (DHT) by an enzyme called 5-alpha reductase.

The effect of DHT on the hormone receptor in the hair follicle is to slow down hair production, thus resulting in weak hair. When that happens hair growth can cease completely. Baldness follows a certain set pattern. It’s usually the temples or the crown of the head that first start balding. Then it spreads to the other areas.

Stress is another cause of baldness. People who lead stressful professional or personal lives, and do not exercise enough, are more prone to baldness than those who are carefree.

Why men are the biggest sufferers

To find out whether men are more likely to suffer from pattern baldness than women you don’t need to consult an expert. Just look around you and you’ll have the answer. Yet why does this happen? The reason is biological. Women’s bodies to not produce the male hormone testosterone that causes male pattern baldness.

The production of testosterone in the male body continues throughout a person’s lifetime. A new supply of this hormone produced by the testicles is always on the way. To make space for these new supplies the older lot gets converted into di-hydro-testosterone (DHT). As the body ejects the DHT, a waste material, the hair follicles in the scalp get clogged and become incapable of holding on to the hair. This is what causes baldness.

People in the 20-45 age group are particularly vulnerable to male pattern baldness. To repeat, both hormonal and lifestyle factors can be the cause of male pattern baldness. Of all the methods of medical hair restoration it is hair transplantation that such people need to go in for. Risk factors in hair transplantation
Hair transplantation is a highly effective method of medical hair restoration. In it the hair-bearing portion of the scalp is removed and transplanted on to the hairless one. What results is natural hair where there was none.

The risks involved in hair transplantation are minor and can include bleeding, infection and scarring. Pre-transplantation anxiety is less easy to quell due to the numerous misconceptions surrounding it. It is normal for patients to become jittery, especially while the hair transplantation surgery is in progress. The long time it takes tends to make the person undergoing surgery restless. Patients report varying degrees of discomfort at the donor site and of the forehead swelling up. The swelling, however, is temporary and recedes within days of surgery. A good surgeon prepares patients well in advance, so as to raise their comfort level and ensure speedy recovery.

Alternatives to surgical hair restoration

Hair transplantation is the only permanent method of hair restoration. There are also some medicines that, when used regularly over an extended period, slow down and, in some cases, even reverse baldness.

Among the medicines that assist medical hair restoration Minoxidil, marketed as Rogaine, is a popular one. It is applied on the scalp twice daily and acts variously on patients, depending on their constitution and the extent of baldness. Having applied the preparation the scalp should be massaged thoroughly, and the treatment pursued over an extended period.

Finasteride, marketed as Propecia, is another medicine which is sold in pill form and taken once a day. The Propecia hair loss treatment is known to work well in cases of male pattern baldness, but only if it is used over a long period of time.

There is also the camouflage solution. As the term implies these colored creams, sprays and powders camouflage the thinning hair areas on the scalp creating the illusion of hair in and about the area where it is thinning.

Painless hair transplantation

Hair transplantation techniques have seen various advances in recent times. All these ensure painless hair transplantation.

The Woods technique of follicular relocation offering painless hair transplantation is really quite different from traditional surgery, which is painful and can cause scarring. The Woods method involves transplanting of only hair and not the excess tissues, as is the case with the older techniques.

This means that the transplant site needs only to nourish the follicles, resulting in a higher take rate and a much lower risk of a fallout caused by localized shock. The method has benefited over 2,000 people so far.

Propecia

Propecia is a safe and reliable method of hair restoration. It prevents the conversion of the male hormone testosterone into di-hydro-testosterone (DHT). The production of testosterone in the testicles is unceasing during a man’s lifetime. As new supplies pour in the testosterone that was present earlier gets converted into DHT – a waste product. While it is getting ejected the DHT clogs the hair follicles of the scalp. As clogged air follicles are unable to hold hair it starts to fall.

The Propecia hair loss treatment blocks the conversion of testosterone into DHT. This hair restoration method uses a steroid type II alpha reductase, which works on the testosterone and synthesizes it in 5-alpha DHT.

Marketed as a pill, Propecia is taken once a day and the treatment continued for at least three months. The Propecia hair loss treatment, however, works only in the case of male pattern baldness.

Side effects of Propecia

The side effects of Propecia are minor, such as hypersensitivity, swelling of the lips and itching. Propecia side effects vary according to the patient’s constitution and disappear after the first few days of treatment, as the body gets adapted to its use.

Hair Restoration Surgery

2011-03-20T00:19:00.000-07:00

Hair restoration includes the medical and surgical treatment of various forms of hair loss. The most common cause of hair loss is androgenetic alopecia (AGA), also known as male pattern baldness or female pattern baldness.

Medical hair restoration

Propecia (Finasteride) is approved for medical hair restoration for men with AGA. Minoxidil is approved for treatment of men and women with AGA

Hair transplant surgery

Surgical hair restoration is the only permanent technique that can move hair from permanent zone to the balding area. Hair restoration surgery is a procedure where natural groupings of 1 to 4 hairs, called follicular units, are extracted from the patient's donor site then moved to the area of balding, called the recipient area. Hair restoration surgery, or hair transplantationhair replacement. The International Society of Hair Restoration Surgery is a medical association of physicians who specialize in hair restoration. has been traditionally used for the treatment of male patterned baldness, but it has gained popularity for treatment of female patterned baldness, eyebrow hair loss, and to restore hair in any part of the body. In addition to cosmetic purposes, hair restoration can be used for treatment of hair loss due to trauma or burn. Hair restoration should be performed by certified surgeons, who specialize in hair replacement. The International Society of Hair Restoration Surgery is a medical association of physicians who specialize in hair restoration

Follicular Unit Transplantation

The gold standard hair restoration surgery technique is Follicular Unit Transplantation (FUT). In FUT, follicular units are extracted from the back of the head, where hair tends to be more permanent, in a strip of skin called the donor strip. Onchttp://www.blogger.com/post-create.g?blogID=7924508181645077758e the strip is removed, the donor area is either sutured or stitched back up, ideally in a way that minimizes scarring. If done properly, the remaining scar, called a line scar, will only be visible with short-cropped hair or a shaved head. After the donor strip is extracted, it is dissected into individual follicular units. These are then transplanted into the recipient area in the patient’s balding scalp where they become viable hair-producing follicles

Hair Restoration Advice for Men and Women

The aim of this web site is to provide you with comprehensive advice and guidance on permanent hair loss solutions. If you are new to hair restoration and hair transplants and would like to review comprehensive information concerning hair restoration surgery, hair restoration advice dot com is for you!

A wide range of articles grouped in different categories are there to provide you with information and advice that in total will provide you with the means to a complete hair loss solution.

Starting with the basics of hair biology and hair loss, the articles gradually introduce you to the whole realm of hair restoration surgery as the final and permanent hair loss solution.

The section how to choose a hair transplant clinic and surgeon helps you to choose a hair transplant center which has both a good reputation and affordable hair restoration costs.

Once you know how to decide on a hair transplant clinic, the next section provides you with a comprehensive guide for interviewing your hair restoration surgeon and what you should expect from a hair transplant doctor.

The successive sections impart information on more practical aspects of hair restoration and provide you with exclusive tips on preparation for the transplant surgery. You can also view in-depth information about the hair loss restoration treatment procedure and get valuable advice on post restoration surgery care.

Hair restoration advice dot com is a totally objective and comprehensive source for hair restoration and hair transplant information on the Internet. Reading through the content presented inthe web pages of hair restoration advice; you are sure to find hair loss solutions and answers to any doubts that you may have about the hair loss restoration aproach.

Hair Loss Restoration Treatment Procedures

The success of any hair loss surgery treatment largely depends upon hair transplantation procedures adopted during the hair restoration surgery. With the emergence of single follicular unit hair transplants as the standard for hair transplant surgery, the hair loss treatment procedures have become more or less standardized in different clinics. A good hair restoration surgeon always uses only these standardized hair loss treatment procedures to achieve aesthetically pleasing results. The standard restoration treatments provide a good hair loss control and permanent balding cures. Good preparation or pre-hair restoration care for the surgical hair restoration is also part of the standard hair restoration treatment procedure.

The following articles provide you the in-depth information about the standard hair loss restoration treatment procedures adopted during the hair restoration surgery. Once you understand these procedures, you are in a better position to question your hair transplant surgeon during the interview and can expect a better control of your hair loss .

Hair Restoration (Replacement) Basics

Surgical hair restoration is a permanent way for men and women to achieve a healthy head of hair. Today's innovative hair restoration treatments help to treat male or female pattern baldness and help individuals who have experienced hair loss. Hair transplants have been available for the treatment of progressive hair loss for over four decades and the techniques have improved significantly over the years. From harvesting donor hair to reducing the amount of tissue that needs to be removed from the donor site, men and women have several options available for hair restoration and hair transplantation.

Hair Restoration (Transplants) Cost & Profile

Avg. Cost: $8000
Candidate: Hair loss
Length: 1-2 hours
Treatments: One or more
Results: Usually Permanent
Back to work: 7 days to 3 months

Hair Transplants & Restoration Basics

If a man is sensitive about losing his hair, transplants may help him feel better about himself, or he can try to put a stop to hair loss with a non-surgical remedy like Propecia which is available by prescription. Either way, a hair transplant physician should assess him to ensure the best course of treatment.

How it's done
Hair is removed from the donor area, and isolated into single or two-haired grafts which are then planted close together to provide a more natural look for your guy. He may have a single treatment or choose to re-visit, depending on the amount of donor hair that he has left. Note: Propecia lowers the amount of the hormone involved in male pattern hair loss and the drug must be used long-term to provide benefits.

Recovery
7 days to 3 months.

Complications
Scarring, numbness and infection can occur.

Cost
$3,000 to $22,000.

Hair Transplant / Restoration

Hair loss and Hair fall are two separate things. Hair fall is a natural daily occurrence. Human head contains over 100,000 hairs and one normally sheds 100 to 150 hairs a day, every hair is genetically programmed. In general 85% of the hair on your head grow approximately 1 centimeter per month for about 2 to 6 years and then fall off. Hair loss is primarily caused by a combination of ageing, a change in hormones and a family history (genetic) of baldness. As a rule, the earlier hair loss begins, the more severe the baldness will become. .

Hair loss can also be caused by burns or trauma, in which case hair replacement is considered a restoration treatment. However, hairs on back of your head are genetically programmed and scheduled to last long. Approximately, 30 percent Indian men will show signs of male pattern baldness by the age of 20. The incidence of male pattern baldness increases 10 percent per decade through a man's life. The causes of female loss range often from iron deficiency to thyroid abnormalities to childbirth. For both sexes, hair loss causes diminished self-esteem, stress, anxiety, depression and feelings of social inadequacy.

Baldness is often blamed on poor circulation to the scalp, vitamin deficiencies, dandruff excessive hat-wearing. All of these theories have been disproved. If hair is a symbol of a person's youth, the loss of it can act as a reminder of approaching old age for men entering their forties.

Female Pattern Hair Loss

The most common type of hair loss seen in women is androgenic alopecia, also known as female pattern alopecia or baldness. This is seen as hair thinning predominantly over the top and sides of the head. It affects approximately one-third of all susceptible women, but is most commonly seen after menopause, although it may begin as early as puberty. Normal hair fall is approximately 100-120 hairs per day. Fortunately, these hairs are replaced. True hairs loss occurs when lost hairs are not re-grown or when the daily hair shed exceeds 125 hairs. Genetically, hair loss can come from either parent's side of the family.
Hair Transplantation In hair restoration (transplantation), it's this non-miniaturized hair on the back and sides that is surgically moved to the top of the head in the form of a tiny skin graft. Because the hair on the permanent horseshoe is genetically programmed to grow a lifetime, it will continue to grow even though it's been transplanted to a different site. This is medical fact, and has been repeatedly proven for more than thirty five years. For some patients, a hairline may need recreation; for others, more extensive hair replacement maybe required. A few patients may want to correct sparse eyebrows or a scar on the scalp. All these individuals, both men and women, are good candidates for the transplant procedure.

How is the procedure performed?
Under local anesthesia, the donor hair grafts are harvested from a strip of skin taken from area between two ears. The strip is divided into small units of skin (grafts), each containing one to three hairs - the follicular units. Then recipient sites are created in the area of hair loss by making small slits in the bald skin. Each site is no bigger than the opening created by the needle used when blood is drawn from your arm. Then each of the grafts is carefully placed into each recipient site. The donor site in the back of the head is not visible. Three to four months later, the transplanted hair begins to grow and continues to grow a half inch per month for the rest of your life.

Why do some Hair Transplants look "more natural" than others?
Although hair transplantation has been performed for almost 35 years, it's never become as popular as you might expect. With good reason it sometimes looks conspicuous and unnatural! One reason is that old fashioned grafts were simply too big. They contained 10 to 20 hairs, and when they grew, tufted doll's head resulted However, if the grafts are made very, very small, with only one follicular unit per graft, the density of the hair can be more evenly distributed and exactly approximate nature's way. This is the basic principle that's used in what's commonly called follicular unit grafting.

What's the difference between a micrograft and a follicular unit graft?
Micro and Follicular unit grafts are often confused. Micrografts are simply grafts which contain either one or two hairs. They are cut randomly from the donor strip with no attention paid to the follicular unit groupings. Follicular unit grafts are actual isolated follicular units that naturally grew in groupings of one, two, or three hairs. In other words, one three haired follicular unit graft could be divided into 3 one haired micrografts.

How is the perfect frontal hairline created?
We use only single grafts in the front hairline, often 100 to 200 of them. Single hair follicular unit grafts are placed in the front rows, and behind them two hair grafts, and behind them the three haired grafts - thus attempting to duplicate the subtle feathered look of a natural thinning hairline. The grafts are delicately handled, refrigerated and submerged in nutrient solution throughout the entire process.

How much pain should I expect? Are there any complications?
Essentially none. Most patients describe the session as easier than a visit to the dentist. Complications rarely occur, but occasionally numbness in the donor site may persist for two or three months after the procedure.

What happens after hair transplant surgery? Patient can resume light work from third day onwards. Sutures on back of head are removed after 7 days. However patient should not do any exercise fro three weeks or shun any activity which will increase pressure in transplanted area. Mild swelling on forehead is possible which disappears after day or two. You can have head bath 4th day onwards. Crusts, scabs and effluvium fall off in next 4 weeks. No special care, medicines or frequent visits to doctor are required.

The hairs will fall out of the newly transplanted follicles within two to six weeks after the procedure - this is normal! So if you are looking to get a Hair Restoration or Hair Transplant Surgery in India then your best option is Cosmetic Surgery Institute at India. You may visit our centers in Mumbai and Goa for a consultation on procedures for Hair Transplantation Surgery by our expert cosmetic surgeons.

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